Miracle-dz/UniFAR-FTUs huggingface dataset:
Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and eating habits program

Abstract Objectives: To determine whether changes in lifestyle in women with BMI > 25 could decrease gestational weight gain and unfavorable pregnancy outcomes. Methods: Women with BMI > 25 were randomized at 1st trimester to no intervention or a Therapeutic Lifestyle Changes (TLC) Program including diet (overweight: 1700 kcal/day, obese: 1800 kcal/day) and mild physical activity (30 min/day, 3 times/week). At baseline and at the 36th week women filled-in a Food Frequency Questionnaire. Outcomes: gestational weight gain, gestational diabetes mellitus, gestational hypertension, preterm delivery. Data stratified by BMI categories. Results: Socio-demographic features were similar between groups (TLC: 33 cases, Controls: 28 cases). At term, gestational weight gain in obese women randomized to TLC group was lower (6.7 ± 4.3 kg) versus controls (10.1 ± 5.6 kg, p = 0.047). Gestational diabetes mellitus, gestational hypertension and preterm delivery were also significantly lower. TLC was an independent factor in preventing gestational weight gain, gestational diabetes mellitus, gestational hypertension. Significant changes in eating habits occurred in the TLC group, which increased the number of snacks, the intake of fruits–vegetables and decreased the consumption of sugar. Conclusions: A caloric restriction associated to changes in eating behavior and constant physical activity, is able to reduce gestational weight gain and related pregnancy complications in obese women.
Maternal plasma levels of interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane and oxidative status in women with preterm premature rupture of membranes

Abstract Objective: Preterm premature rupture of membranes (PPROM) is associated with significant maternal and perinatal morbidity. This study examined maternal oxidative stress in PPROM. Methods: This was a prospective cross-sectional study conducted in a university hospital. A total of 72 pregnant women were recruited into two groups, those with PPROM (38 cases) and those without PPROM (34 controls) matched for gestational age. Plasma interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane, total oxidant status (TOS) and antioxidant status (TAS) were determined for all study participants and the data were compared between the PPROM and control groups. Results: Both case and control groups were comparably matched in age, parity, gestational age and smoking status. There was a significant association between low 8-isoprostane, low vitamin C and high total oxidant status and the occurrence of PPROM (p < 0.001). Conclusions: Plasma vitamin C and 8-isoprostane levels were lower and TOS higher in women with PPROM. Further research is needed to identify robust biological markers for the prevention and also prognosis of PPROM.
The effect of placental abruption on the outcome of extremely premature infants

Abstract Objective: To determine the effect of placental abruption on the outcome of infants born between 22 and 26 weeks of gestation. Methods: A retrospective study involving 32 cases of placental abruption. Controls were matched to cases according to gestational age and birth weight. Medical records were reviewed to confirm maternal background and neonatal outcome. We compared characteristics of maternal background and neonatal outcome between the two groups. Results: There were no significant differences in the incidence of pregnancy-induced hypertension, low maternal fibrinogen (<200 mg/dl), premature rupture of membrane, intrauterine infection, ischemic changes of the placenta, or funisitis between the groups. Non-reassuring fetal heart rate patterns (NRFHRs) during intrapartum were frequently seen in the placental abruption group compared to controls (75% versus 51%, p = 0.02). However, no differences were found for the incidence of low umbilical artery pH (<7.1), cerebral palsy, or neonatal death. The incidence of chronic lung disease (CLD, 66% versus 43%, p = 0.04) and hemosiderin deposition on the placenta (16% versus 0%, p < 0.01) was higher in abruptions compared to controls. Conclusion: Placental abruption has a risk for the development of NRFHRs and CLD in infants born between 22 and 26 weeks of gestation, but shows no effect on neonatal mortality.
Automatic extraction of coronary artery tree on coronary angiograms by morphological operators

This paper presents a new method of fully automatic detection of the coronary artery tree by using several morphological filters. The contrast between coronary artery and background is enhanced by the morphological Top-Hat operation and subtraction of the result from the original image. Pixels which are obviously out of the coronary artery are removed by the half-threshold processing and the erosion operation. The labeling according to gray level difference is done on the half-threshold image so as to extract the candidates of the coronary artery. The main part of the coronary artery is extracted as the biggest area among the labeled areas. Because the tip parts of the coronary artery are narrower than the area of main coronary artery, multi-structure elements of Top-Hat operator are used repeatedly to enhance the narrow artery. The morphological watershed transform is used to detect the edge of coronary artery on the gradient image of the original image. We have tried the method on several images. Results show that the method is efficient to detect the artery tree automatically even on a less contrast image.
On the expectation of errors of allocation associated with a linear discriminant function

SUMMARY Exact expressions are obtained for the expectations of the actual, apparent and estimated errors of allocation which result when a linear discriminant function is used to allocate individuals to one of two multivariate normal populations with a known common dispersion matrix. Approximations suggested in the literature for the expectation of the actual error of allocation are compared with the exact values.
Automobile Safety in Children: A Review of North American Evidence and Recommendations

&NA; In the United States, the rate of vehicle occupant deaths in children aged 1 to 3 years has decreased by over 50% in the past three decades. However, the Centers for Disease Control and Prevention report that motor vehicle crashes remain the leading cause of death in children aged 1 to 17 years. Parental compliance with child safety seats is poor, with up to 99% of children in certain age groups improperly restrained. Epidemiologic data support the proper use of automobile restraint systems to save lives. When appropriate restraint systems (based on age and weight) are used, a significant decrease occurs in the rates of mortality and serious injury. Legislation and public service campaigns can increase awareness regarding appropriate use of automobile restraint systems to decrease pediatric injury and fatality rates. Fluency and awareness, rather than cost, have been found to be the main reasons for improper use of automobile restraint systems; appropriately targeted education programs should continue to be developed. Physicians are optimally poised to educate patients and parents about automobile safety.
Sarcoma Chemotherapy

&NA; Sarcomas are a rare, heterogeneous group of malignant tumors of the bone or soft tissue. Although historically intended for the pharmaceutical treatment of microbes, today chemotherapy is used in orthopaedic oncology and is arguably the primary reason for improved survivorship. Agents such as anthracyclines (eg, doxorubicin), alkylating agents (eg, cyclophosphamide, ifosfamide), antimetabolites (eg, methotrexate), topoisomerase inhibitors (eg, etoposide [VP‐16]), vinca alkaloids (eg, vincristine), and cytotoxic antibiotics (eg, actinomycin D) are used in various combinations to manage different types of tumors. Side effects are common and range from mild to severe. The effectiveness of the chemotherapy regimen correlates with the extent of tumor necrosis.
Treatment of Distal Radius Fractures

&NA; The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria (AUC) for treating distal radius fractures (DRF). Evidence‐based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The DRF AUC clinical patient scenarios were derived from patient indications that generally accompany a DRF, as well as from current evidence‐based clinical practice guidelines and supporting literature. The 216 indications and 10 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. Next, the Review Panel, a separate group of volunteer physicians, independently reviewed these materials to ensure that they were representative of patient scenarios that clinicians are likely to encounter in daily practice. Finally, the multidisciplinary Voting Panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9‐point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).
Significant correlation between BMI/BW with insulin resistance by McAuley, HOMA and QUICKI indices after 3 months of pioglitazone in diabetic population

Twenty-four patients of type 2 diabetes with fasting blood glucose (FBG) > 7 mmol/l (126 mg/dl) were randomly selected on one (if the patient is symptomatic) or two occasions (if the patient is asymptomatic). Patients were treated with 15 mg of PIO daily and investigated for BW, BMI, FBG, fasting insulin (FI) and triglycerides (TG). IR was calculated by McAuley (McA), homeostasis model assessment (HOMA) and QUICKI indices at baseline and repeated after 3 months.
Male and Female Differences in Musculoskeletal Disease

Gender differences exist in the presentation of musculoskeletal disease, and recognition of the differences between men and women’s burden of disease and response to treatment is key in optimizing care of orthopaedic patients. The role of structural anatomy differences, hormones, and genetics are factors to consider in the analysis of differential injury and arthritic patterns between genders.
Treatment of Anterior Cruciate Ligament Injuries

The American Academy of Orthopaedic Surgeons has developed the Appropriate Use Criteria (AUC) document Treatment of Anterior Cruciate Ligament Injuries. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain the best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC clinical patient scenarios were derived from patient indications that generally accompany an anterior cruciate ligament injury, as well as from current evidence-based clinical practice guidelines and supporting literature. The 56 patient scenarios and 8 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. Lastly, a separate, multidisciplinary Voting Panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).
Interpreting Echoes: Why Bats Are Better Than US

Ultrasound has been utilised by medical professionals for the past 50 years as a tool to investigate living tissue non-invasively. There have been great technological advances to increase the effectiveness of the equipment used to image with ultrasonography, but there may still be important lessons to learn from animals that similarly employ ultrasound to assess their environment, such as bats. Despite most species having good eyesight, bats are widely recognised for having a finely-tuned ability to both emit ultrasonic pulses and interpret the resulting echoes from both moving and stationary targets with pin-point accuracy. They achieve target detection, localisation and classification using a variety of methods to enhance the information extracted from the echoes of their emitted ultrasonic pulses. This paper outlines the principles of the echolocation employed by bats and provides a comparison with the features used for medical ultrasonography, highlighting the differences that allow bats to remain ahead of the field.
Five-year Survival Rate in Hemodialysis Patients Attending Sari Imam Khomeini Hospital

Background and purpose: Today chronic kidney disease is considered as a serious health problem in the world. In end-stage renal disease patients are dependent on replacement therapies including hemodialysis. This study investigated the 5-year survival rate of hemodialysis patients admitted to Sari Imam Khomeini Hospital. Materials and methods: This longitudinal descriptive study was performed in 200 hemodialysis patients between 2007-2012. Statistical analysis was done using the Kaplan-Meier method and compared by the Log-Rank test. We also performed multivariate analysis to determine the most important factors affecting the prognosis of survival of patients using Cox regression analysis. Results: The mean age of the patients was 62.4±16.5 years and the mean and median survival rate were 35.95 months and 37 months, respectively. In univariate analysis using the Kaplan-Meier method, the overall 1-,2-,3-,4-,5-year survival rates for hemodialysis patients were 75%, 63%, 50% ,41%, and 23%, respectively. In multivariate analysis using Cox regression model, the age and mean serum albumin were identified as important factors in the survival of hemodialysis patients. Conclusion: This study observed a low survival rate among hemodialysis patients. Obviously this rate could increase if the disease is diagnosed at earlier stages and also if the patient could receive high quality treatments through monthly follow-ups.
Serotonin transporter gene polymorphisms in patients with chronic tension-type headache: a preliminary study.

BACKGROUND AND OBJECTIVES This study is designed to understand the pathophysiology of one of the most serious health problems, chronic tension-type headache (CTTH). Two polymorphic sites in serotonin transporter protein gene attracted much interest. These are: the variable number of tandem repeats (VNTR) and 5'-flanking promoter region (5-HTTLPR). MATERIALS AND METHODS VNTR and 5-HTTLPR polymorphisms were investigated in 126 CTTH patients and 138 healthy control subjects. The patients were being treated with amitripytyline or citalopram or sertraline (SSRI). The polymerase chain reaction (PCR) method was used to investigate the polymorphisms in the serotonin transporter protein gene. RESULTS There were no statistically significant results based on the 5-HTTLPR gene alleles, however, STin 2.12/12 genotype and STin 2.12 allele were seen to predominate the control group. In order to investigate the combined effect of the two polymorphic loci on the 5-HTT gene expression, samples were separated into nine groups. Genotypes (S/S-12/10) and (L/S-12/10) displayed statistically significant frequency in the CTTH group than in the control group. No significant differences were noticed between the 5-HTTLPR and VNTR haplotype groups and success in treatment. CONCLUSION It is possible to make reliable comparisons and hypothesis about the homozygous and/or heterozygous presence of S and STin 12/10 alleles which may be in interaction with CTTH. On the other hand, the presence of homozygous L and STin12 alleles may play a protective role against CTTH. It is also possible that heterogeneity among diseases showing the same clinical research will require a lot of effort for individual identification.
GeneXpert® MTB/RIF for rapid detection of Mycobacterium tuberculosis in pulmonary and extra-pulmonary samples.

of IPT in low-income settings, based on screening for symptoms among HIV-infected patients,2 has major limitations: the symptom screen alone misses a considerable proportion of patients with culture-proven TB, particularly in regions with high TB prevalence. Further research on screening approaches is urgently needed, including on the automated molecular testing system GeneXpert MTB/RIF, which Lawn presents as a safe tool for reliably excluding TB in HIVinfected patients before IPT initiation. Such an assay may prove to be a major step forward. We would, however, like to sound a note of caution: both a high sensitivity and reasonably high specifi city are required for a test to reliably rule out a condition.3 Taking the sensitivity of 73% given by Lawn, and assuming a specifi city of 99%, results in a likelihood ratio of a negative test of 0.27. A negative GeneXpert MTB/ RIF test would thus reduce the pre-test probability of 15% quoted by Lawn to 4.6%. Finally, we stress that the survey of practices reported in our article was from 2008 and may not r efl ect the current situation. Since then, numerous clinical trials on IPT and the new WHO guidelines on IPT implementation in ART programmes have been published. We plan to repeat our survey in the near future within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA) in sub-Saharan Africa.4
Burden of tuberculosis in indigenous peoples globally: a systematic review.

BACKGROUND The burden of tuberculosis (TB) in the estimated 370 million indigenous peoples worldwide is unknown. OBJECTIVE To conduct a literature review to summarize the TB burden in indigenous peoples, identify gaps in current knowledge, and provide the foundation for a research agenda prioritizing indigenous health within TB control. METHODS A systematic literature review identified articles published between January 1990 and November 2011 quantifying TB disease burden in indigenous populations worldwide. RESULTS Among the 91 articles from 19 countries included in the review, only 56 were from outside Australia, Canada, New Zealand and the United States. The majority of the studies showed higher TB rates among indigenous groups than non-indigenous groups. Studies from the Amazon generally reported the highest TB prevalence and incidence, but select populations from South-East Asia and Africa were found to have similarly high rates of TB. In North America, the Inuit had the highest reported TB incidence (156/100000), whereas the Metis of Canada and American Indians/Alaska Natives experienced rates of <10/100000. New Zealand's Maori and Pacific Islanders had higher TB incidence rates than Australian Aborigines, but all were at greater risk of developing TB than non-indigenous groups. CONCLUSION Where data exist, indigenous peoples were generally found to have higher rates of TB disease than non-indigenous peoples; however, this burden varied greatly. The paucity of published information on TB burden among indigenous peoples highlights the need to implement and improve TB surveillance to better measure and understand global disparities in TB rates.
Chronic Illness Self-Management While Living Alone in Later Life

Older people living alone (OPLA) are considered vulnerable because of fewer resources, such as social support. As self-management becomes increasingly important in chronic care, evidence is needed on how to better support OPLA. This review synthesizes the evidence from 32 publications on the challenges as well as strategies of OPLA in managing chronic conditions. On the basis of a systematic database search and review process, being independent and being at home were identified as crucial when living alone in later life; both involve decision making and the adjustment of routines to manage everyday life and chronic conditions. These findings show that OPLA are vulnerable because of difficult living situations, limited resources, or a lack of support, and they actively manage their conditions using various strategies to remain independent, but these may cause fragile arrangements that can jeopardize independence. Awareness of these strategies is a starting point to develop interventions for self-management support in chronic illness.
Direct comparison of two new actigraphs and polysomnography in children and adolescents.

STUDY OBJECTIVES To evaluate the validity and reliability of 2 new models of commercially available actigraphs compared to polysomnography for children and adolescents. DESIGN AND SETTING Subjects concurrently wore the Ambulatory Monitoring Inc. Motionlogger Sleep Watch (AMI) and the Phillips Respironics Mini-Mitter Actiwatch-2 (PRMM) while undergoing overnight polysomnography (PSG) in a pediatric sleep laboratory housed in a tertiary care children's hospital. PARTICIPANTS 115 youth (59 girls, 56 boys), ages 3-18 years (mean 8.8 years, SD 4.4 years). MEASUREMENTS Outcome variables were total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE). Epoch-by-epoch comparisons were made between the 2 devices and PSG to determine sensitivity, specificity, and accuracy. Agreement between the 2 devices was determined with t-tests and the Bland-Altman concordance technique. Different algorithms/sensitivities, developmental age groups, and sleep disordered breathing (SDB) status were also examined. RESULTS For both device brands, sensitivity (0.89-0.97), specificity (0.54-0.77), and accuracy (0.87-0.90) were similar to previous reports. Notably, compared to PSG, both device brands significantly overestimated WASO, while the AMI device also significantly underestimated TST. Inter-device comparison of the 2 brands found poor agreement for TST, WASO, and SE. Agreement with PSG differed depending on the scoring algorithm (AMI) or sensitivity setting (PRMM), as well as across developmental age group and sleep disordered breathing (SDB) status. CONCLUSIONS Similar to previous reports, both new actigraph brands were found to have good sensitivity (to detect sleep), but poorer specificity (to detect wake). Study results also suggest that researchers should adjust the scoring algorithm/sensitivity depending on a study's design (e.g., young children vs. adolescents, healthy children vs. youth with SDB). Further, inter-device reliability was poor, suggesting the need for caution when comparing results across studies that use different brands of actigraphic devices.