Miracle-dz/UniFAR-FTUs huggingface dataset:
Assessing the quality of evidence supporting patent foramen ovale closure over medical therapy after cryptogenic stroke.

We read the recent article by Ahmad et al. with interest. This systematic review and meta-analysis compared patent foramen ovale (PFO) closure to medical therapy for patients with cryptogenic stroke. After pooling data from five studies, the authors concluded that PFO closure is superior to medical therapy (hazard ratio 0.32, 95% confidence interval 0.13–0.82, I = 73%), and called for updated guidelines reflecting these findings. When appraising the methodological rigor of the evidence, the authors concluded that the overall quality of individual trials was either ‘intermediate’ or ‘high’ and they did not provide an evaluation of their overall confidence in the body of evidence. In the approach recommended by GRADE, included trials should be dichotomized as high or low risk of bias according to the Cochrane framework. We applied this framework based on the information provided in Table 2; our judgements differed from those made by the study authors (Figure 1). In the PC, REDUCE, and RESPECT trials, the number of patients who were lost to follow-up in the intervention arm were large and exceeded the fragility index. Hence, we disagree that these trials were at low risk of attrition bias. We agree with Ahmad et al. that the open-label CLOSE, CLOSURE, and REDUCE trials were at risk of detection bias due to non-blinded adjudication. In consequence, each of the five trials in this meta-analysis is at risk of detection bias, attrition bias, or both biases; this places them at high overall risk of bias. Ahmad et al. also failed to consider other factors that affect quality of evidence. In the GRADE framework, summary findings based on randomized controlled trials start as high quality evidence but can be downgraded based on five categories—risk of bias, imprecision, inconsistency (also known as heterogeneity), indirectness, and publication bias. The summary data presented by the review authors is therefore of low quality, requiring downgrading for serious risk of bias, and substantial heterogeneity (I = 73%). Figure 1 Risk of bias summary: revised judgements about each risk of bias item for each included study. The green circles with ‘þ’ denote a low risk of bias for this study in this domain, the red circles with ‘-’ denote a high risk of bias for this study in this domain, and the yellow circles with ‘? ’ denote an unclear risk of bias for this study in this domain.
Teaching Midwifery Face-to-Face or Via the Screen: The Impact of Flexible Delivery of Teaching on Student Engagement

The aim of this research was to describe how undergraduate midwifery students’ engagement with learning is impacted when they have teaching delivered by different methods of instruction. It asks the question: does flexible delivery of teaching impact on their ability to engage in their learning? This research describes the impact of different modes of flexible delivery of teaching within a new curriculum on students in a pre-registration midwifery undergraduate programme at Waikato Institute of Technology (Wintec), New Zealand. This new curriculum commenced in 2010 as a response to legislative and industry driven changes to midwifery education in New Zealand. The research used an on-line survey to ask students enrolled in years one and two of the programme and those who had exited the programme during the same timeframe, A range of questions about their learning experiences. Surveys were sent to 104 enrolled students and 15 students that had exited the BMid programme. Fifty two (50%) responses were received from the enrolled students and three (20%) from those that had exited the programme. There were three key findings of this research. Firstly the participants identified differences with their sense of belonging amongst their peers, tutors and the administration team outside of their regional learning hubs. The second key and unsurprising finding was that respondents across the board preferred face-to-face sessions to video conferencing sessions and thirdly that the demographic profile of the respondents from the regional learning hubs was different to those attending from the Hamilton city hub. The implications of these key findings are; · For tertiary institutions to acknowledge and consider the links between high quality learning, student engagement and outcomes. · To support the need for continuing training and education for both faculty and students with regards to flexible delivery of teaching and to provide professional development and relevant technology to support more interactive forms of learning if delivered via video conferencing or by online activities. · To further research the needs of Māori students and those who have exited the programme in order to discover what would need to change in order for them to continue with their studies.
The challenge of Fetal Alcohol Syndrome: Overcoming secondary disabilities.

In the first book of its kind, experts describe how to help people with Fetal Alcohol Syndrome. A summary of recent findings and recommendations is presented by the team who conducted the largest study ever done on people of all ages with Fetal Alcohol Syndrome and Fetal Alcohol Effects. Twenty-one experts from the fields of human services, education, and criminal justice respond by describing their solutions to this problem of a birth defect that targets the brain and has lifelong consequences. Some of the most crippling secondary disabilities that people with FAS/FAE face include mental health problems, disrupted school experience, inappropriate sexual behavior, trouble with the law, alcohol and drug problems, difficulty caring for their children, and homelessness. This book acknowledges the diverse and multifaceted needs of people with FAS/FAE across the lifespan. It will be valuable for parents and the many professionals working with people with FAS/FAE.
Sucking Organization Following an Infant‐Directed Developmental Intervention

Newborn Care Paper Presentation Objective To evaluate sucking organization in premature infants following a multisensory intervention compared with infants assigned to a control group. Design Experimental design. Setting Two community‐based neonatal intensive care units. Sample A convenience sample of 185 healthy premature infants born between 29‐ and 34‐week gestation was recruited. Methods This randomized trial was used to test the Impacts of Hospital‐Home Transition: Optimizing Prematures' Environment (H‐HOPE). The intervention included infant remediation using a multisensory approach (the auditory, tactile, visual, and vestibular intervention) and maternal redefinition and re‐education, using maternal participatory guidance. Sucking organization was measured at baseline (prior to random assignment to the experimental or control groups) followed by weekly assessments during the infant's hospital stay. Sucking organization was measured by the number of sucks, number of sucks per burst, and sucking pressure. A sucking maturity index was constructed from these three variables. Results At baseline, there were no significant differences between the H‐HOPE and control groups for number of sucks, number of sucks per burst, and sucking pressure. During the course of the infants' hospitalization, significant increases in the number of sucks ( p p p p Conclusion/Implications for Nursing Practice Inefficient oral feeding resulting from immature behavioral organization requires substantial energy expenditure and delays hospital progression, thus increasing costs. Failure to coordinate breathing, sucking, and swallowing predisposes the premature infant to apneic events, bradycardia and oxygen desaturation, and fatigue during feeding. Slight arousal prior to feeding helps infants achieve an active awake state, which is conducive to nipple feeding. H‐HOPE infants exhibited improved sucking organization over the course of hospitalization, suggestive that this intervention improves oral feeding.
Evolución de algunos indicadores alimentario-nutricionales en Cuba a partir de 1993

mo ión po de Entre los factores involucrados en el origen de neuropatía epidémica (NE) se encuentran los de t alimentario-nutricional, por lo que resulta de gra importancia el seguimiento permanente del consu aparente y acceso a los alimentos, y del estado nutricio En Cuba se obtiene la evolución de algun indicadores de la cadena alimentaria mediante el Sist de Vigilancia Alimentaria y Nutricional (SISVAN), al cua se le adicionó en 1994 la vigilancia del acceso a alimentos, indicador necesario frente a las nuevas form de producción y distribución. De forma adicional s brindan algunos resultados del estado nutricion obtenidos en grupos específicos de poblaci supuestamente sana. A continuación se presenta la evolución de algun indicadores alimentario-nutricionales a partir de 1993.
The Effects of Calcium Channel Blockade and Atrial Natriuretic Peptide Signalling on Proliferation and Differentiation of Cardiac Progenitor Cells

xiv LIST OF ABBREVIATIONS AND SYMBOLS USED . xv ACKNOWLEDGEMENTS . xx CHAPTER 1: INTRODUCTION . 1 1.1 Thesis Overview . 1 1.2 Cardiovascular Anatomy and Physiology . 4 1.2. 1 The Cardiovascular System: Form and Function . 4 1.2. 2 The Cardiac Conduction System . 8 1.2. 3 The Endocrine Function of the Heart . 10 1.2. 4 Ultrastructural Features of the Cardiomyocyte . 10 1.2. 5 Excitation Contraction Coupling . 12 1.2. 6 The Cardiomyogenic Origin of Working and Conduction System Cardiomyocytes . 13 1.3 Cardiogenesis. 13 1.3. 1 The Cardiogenic Fields and Heart Tube Formation . 14 1.3. 2 Induction and Differentiation of the Myocardium . 16 1.3. 3 Cardiac Looping and Formation of the Four Chambered Heart . 20 1.3. 4 Development of the Cardiac Conduction System . 21 1.3. 5 Undifferentiated Cardiac Progenitor Cells in the Embryonic Heart PostChamber Formation . 23
Prognostic Impact of Perirenal Fat or Adrenal Gland Involvement in Renal Cell Carcinoma Exhibiting Venous Vascular Extension

Venous vascular extension is one of the aggressive tumor behaviors especially for renal cell carcinoma (RCC). It has been reported that 4% to 10% have tumor thrombus extending into the venous system among patients with newly diagnosed RCC (Marshall et al., 1970; Hoehn & Hermanek, 1983; Casanova & Zingg, 1991; Hatcher et al., 1991; Pagano et al., 1992). Compared with conservative treatment regimens, surgical resection remains the most effective treatment for these patients (Staehler & Brkovic, 2000). The mean 5-year survival rates of such patients with inferior vena cava involvement undergoing radical surgery for RCC have been reported as 32% to 64% (Neves & Zincke, 1987; Skinner et al., 1989; Montie et al., 1991; Swierzewski et al., 1994; Glazer & Novick, 1996).
Tenting area reflects disease severity and prognosis in patients with non‐ischaemic dilated cardiomyopathy and functional mitral regurgitation

To define which echocardiographic parameters are related to the degree of functional mitral regurgitation (FMR) and to establish their relationship with clinical status, plasma B‐type natriuretic peptide (BNP) levels, and prognosis in patients with non‐ischaemic dilated cardiomyopathy (NICMP).
Cost‐effectiveness of highly purified omega‐3 polyunsaturated fatty acid ethyl esters in the treatment of chronic heart failure: results of Markov modelling in a UK setting

A recent randomized placebo‐controlled clinical trial has reported reductions in mortality and hospitalizations in patients with chronic heart failure (CHF) who were prescribed highly purified omega‐3 polyunsaturated fatty acid ethyl esters (n‐3 PUFA). This study aimed at evaluating the cost and benefits associated with their use in the treatment of CHF in a UK setting.
Evidence-based medicine--an oral history.

The phrase evidence-based medicine (EBM) was coined by Gordon Guyatt1 and then appeared in an article in The Rational Clinical Examination series in JAMA in 1992,2 but the roots of EBM go much further back. The personal stories of the origins of EBM were recently explored in a filmed oral history of some of the individuals most strongly associated with the birth of the movement (see Video, Evidence-Based Medicine: An Oral History). JAMA and the BMJ invited 6 individuals (including us, with one of us as host, R.S.) who have played a prominent part in the development of EBM to participate in an oral history event and filming. Videos of this event and of interviews with 3 other EBM leaders (Box) have been woven together and may be accessed at http://ebm.jamanetwork. com. Just 20 years after the term EBM began to be used, an early and informal history has emerged.
Assessment of body composition in lactating mothers in a rural African community using deuterium oxide

Abstract Background and objective. The deuterium oxide (DO) dilution method for measuring body composition was validated against the widely used skinfold (SF) measurement-based equation of Durnin and Womersley. The study involved 10 lactating women living in a rural community in Nandi, Kenya and participating in a cross-sectional study aimed at determining their iron and vitamin A status. Methods. The selection criteria were exclusive breast-feeding, infants between 2 and 4 months of age, maternal parity < 4, birth weight more than 2 500 g and no congenital abnormalities. Maternal and infant anthropometric measurements were taken. DO (approximately 0.1 g 2H2O/kg body water) was given orally to each mother accordingly to the Maastricht protocol (DO) for total body water (TBW) determination. The 2H enrichment of the urine was measured using gas-isotope-ratio mass spectrometry. Blood samples were collected. Serum retinol and ferritin were determined using high- performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA) respectively. Body mass index (BMI) was determined as weight/height (m2). The Bland-Altman pair-wise comparison was used to compare maternal fat-free mass (FFM), body fat (BF) and percentage body fat (% BF) that were determined based on the DO and SF techniques. Results. Maternal mean (± standard deviation (SD)) for parity, age, BMI, haemoglobin (Hb), serum ferritin and serum retinol were 3 (2), 26 (4) years, 23.4 (4), 12.1 (1.8) g/dl, 10.3 (4.0) µg/l and 0.696 (0.300) µmol/l respectively. The FFM, BF and % BF accordingly to the DO and SF methods respectively were 44.0 (4.7) kg v. 42.9 (5.9) kg, 16.7 (8.8) kg v. 17.8 (7.5) kg and 26.2 (8.1)% v. 28.4 (6.4)%. Limits of agreement for underestimation of FFM and % BF were 4.4 kg (SEE 3.4) and 11.6% (SEE 5.8) respectively. Bias in the measurement of FFM and % BF was 1.1 kg (SEE 1.9), and —2.2% (SEE 3.3) respectively. Conclusion. The variability (5.8 - 17.5%) observed in the SF technique may result in lower prediction of % BF. This may be an important factor for community-based nutritional interventions that aim at improving the body composition of vulnerable groups such as pregnant and lactating women or subjectswith severe undernutrition.
ISOLATION AND CHARACTERIZATION OF A NOVEL CHEMICAL COMPOUND FROM EUGENIA CARYOPHYLLUS FLOWER BUD EXTRACT

Objective: The objective of this study was to isolate and characterize the bioactive principles from the aqueous ethanolic extract of flower buds of Eugenia caryophyllus . Methods: The isolation was done using column chromatography using gradient elution with different mobile phases. The isolated compound was subjected to spectral analysis. Structure elucidation was carried out on basis of spectral analysis. Results: The infra-red spectra showed specific absorption bands for flavanoids viz. 1245.86 to 1111.01 cm -1 for HCO stretch of ether; 1330 to 1050 cm -1 for CO stretch of lactone. In addition IR spectrum showed specific absorption bands for flavanoids viz. 3432.57cm -1 for OH stretch for alcohol and phenol. Mass spectra showed pseudomolecular ion (M + ion) peak at m/z 464 which corresponds to molecular formula C 21 H 20 O 12 . Conclusion: From the spectral characteristics, the isolated compound from the extract was confirmed to be Gossypetin 7-O rhamnopyranoside (Rhodiolgin). Keywords : Eugenia caryophyllus , Myrtaceae, Flower buds, Gossypetin, Syzygium aromaticum
Influence of age, race, sex, and body mass index on interpretation of midregional pro atrial natriuretic peptide for the diagnosis of acute heart failure: results from the BACH multinational study

Midregional pro atrial natriuretic peptide (MR‐proANP) is useful for diagnosing acute heart failure (HF) in patients presenting to the Emergency Department with dyspnoea. Optimal interpretation of MR‐proANP requires understanding of how various demographic variables influence its levels and performance as a diagnostic marker. We sought to determine how age, race, sex, and body mass index (BMI) affect the levels and interpretation of MR‐proANP for the diagnosis of acute HF.
Educational achievement and economic self-sufficiency in adults after childhood bacterial meningitis.

IMPORTANCE To our knowledge, no previous study has examined functioning in adult life among persons who had bacterial meningitis in childhood. OBJECTIVE To study educational achievement and economic self-sufficiency in adults diagnosed as having bacterial meningitis in childhood. DESIGN, SETTING, AND PARTICIPANTS Nationwide population-based cohort study using national registries of Danish-born children diagnosed as having meningococcal, pneumococcal, or Haemophilus influenzae meningitis in the period 1977-2007 (n=2784 patients). Comparison cohorts from the same population individually matched on age and sex were identified, as were siblings of all study participants. End of study period was 2010. MAIN OUTCOMES AND MEASURES Cumulative incidences of completed vocational education, high school education, higher education, time to first full year of economic self-sufficiency, and receipt of disability pension and differences in these outcomes at age 35 years among meningitis patients, comparison cohorts, and siblings. RESULTS By age 35 years, among persons who had a history of childhood meningococcal (n=1338), pneumococcal (n=455), and H. influenzae (n=991) meningitis, an estimated 11.0% (41.5% vs 52.5%; 95% CI, 7.3%-14.7%), 10.2% (42.6% vs 52.8%; 95% CI, 3.8%-16.6%), and 5.5% (47.7% vs 53.2%; 95% CI, 1.9%-9.1%) fewer persons, respectively, had completed high school and 7.9% (29.3% vs 37.2%; 95% CI, 1.6%-14.2%), 8.9% (28.1% vs 37.0%; 95% CI, 0.6%-17.2%), and 6.5% (33.5% vs 40.0%; 95% CI, 1.4%-11.6%) fewer had attained a higher education compared with individuals from the comparison cohort. Siblings of meningococcal meningitis patients also had lower educational achievements, while educational achievements of siblings of pneumococcal and H. influenzae meningitis patients did not differ substantially from those in the general population. At end of follow-up, 3.8% (90.3% vs 94.1%; 95% CI, 1.1%-6.5%), 10.6% (84.0% vs 94.6%; 95% CI, 5.1%-16.1%), and 4.3% (90.6% vs 94.9%; 95% CI, 2.0%-6.6%) fewer meningococcal, pneumococcal, and H. influenzae meningitis patients were economically self-sufficient and 1.5% (3.7% vs 2.3%; 95% CI, -0.2% to 3.2%), 8.7% (10.0% vs 1.3%; 95% CI, 5.0%-12.4%), and 3.7% (6.2% vs 2.5%; 95% CI, 1.6%-5.8%) more received disability pension compared with individuals from the comparison cohort. CONCLUSIONS AND RELEVANCE In a Danish population, bacterial meningitis in childhood was associated with lower educational achievement and economic self-sufficiency in adult life. This association may apply particularly to pneumococcal and H. influenzae meningitis, whereas for meningococcal meningitis the lower educational achievement may be family-related.
Eye Movement Recording Approach Combined with Task Classification and Its Application to Clinical Engineers in Actual Working Environment

: The present paper demonstrates the potential of an eye movement-based approach to cognitive task analysis in a dialysis room. An analysis framework composed of a task classification scheme and a series of steps for data processing was developed. The framework makes it possible to trace the cognitive aspects of clinical engineer behavior in real work situations. The framework developed was applied to observation data (including eye movement data) obtained from eight clinical engineers working at a hospital. In the eye movement data, we found a slight tendency for engineers having long careers to show relatively superior behavior among all engineers observed in terms of their attention allocation processes toward key information. Based on the analysis results, we discuss the feasibility of the proposed analysis framework and some implications for improving the eye movement-based approach for practical use.
Factors affecting the activities of microbicides

The antimicrobial activities of microbicides can be profoundly affected by factors such as concentration of the active(s), contact time, temperature, pH, degree and type of soiling, nature and topography of the target surface/object, excipients in the formulation, type and level of microbial contamination and the presence of microbial biofilms. Thus, understanding the influence of these factors, singly or in various combinations, is vital not only to design effective and safer microbicides but also to apply them optimally in the field. Such knowledge is more essential now than ever due to increasing numbers of microbicidal products and their widening applications. Inappropriate and/or sub-optimal use of such products may contribute to human and environmental toxicity and also induce resistance to antibiotics and other microbicides. This chapter is a general review on how the above-mentioned factors may influence the microbicidal activity of chemicals during the initial development of a given formulation, its actual field use and in assessing the outcome of its application.
Incidence of oesophageal wall injury post-pulmonary vein antrum isolation for treatment of patients with atrial fibrillation.

AIMS Oesophageal injury has been reported with delivery of radio-frequency lesions at the left atrium posterior wall in catheter ablation procedures for atrial fibrillation (AF). In this observational study we prospectively assessed endoscopical oesophageal wall changes after pulmonary vein antrum isolation (PVAI) in patients presenting for treatment of AF. METHODS AND RESULTS Twenty eight patients (18 men; mean age 55 +/- 11 years) were ablated using either a cooled-tip or an 8 mm tip ablation catheter. Endoscopy of the oesophagus was performed 24 h after PVAI. If oesophageal wall changes were detected post ablation, a proton-pump inhibitor (PPI) was started and repeat endoscopy was considered. Within 24 h post ablation oesophageal wall changes were confirmed in 47% of our study patients. Erythema was identified in 29% and necrotic or ulcer-like changes in 18% of patients. None of study patients experienced left atrial-oesophageal fistula. A significant correlation between Reflux-like symptoms and oesophageal wall changes was demonstrated. Complete recovery of oesophageal lesions was shown in all study patients 2-4 weeks post ablation. CONCLUSION A significant number of patients experienced oesophageal wall injury post PVAI. Initiating PPIs in this group of patients might facilitate recovery of oesophageal wall injuries caused by radio-frequency energy delivery.