Miracle-dz/UniFAR-FTUs huggingface dataset:
The Evolution of Mortality and Death Causes in Type 2 Diabetes Patients from Timisoara Diabetes Centre Between 1970 And 1999

Abstract Background and Aims: Cardiovascular disease represents the principal cause of death in type 2 diabetes (T2DM) patients. The aim of our study was to evaluate the all cause mortality and the main causes of death in T2DM patients and their trend of evolution between 1970 and 1999. Material and methods: 3719 T2DM patients newly diagnosed between 1970-1979 in the Timisoara Diabetes, Nutrition and Metabolic Diseases Centre were followed until 1999. The study group included 2084 women (56.0%) and 1635 men (44%), with a mean age at diagnosis of 58.2±11.5 years. Results: Throughout the analyzed period we noticed a tendency of decrease for all cause mortality, the main causes of death being cardiovascular diseases. Conclusions: The results of the study confirm the tendency of reduced mortality in T2DM patients and maintenance of cardiovascular diseases as the main cause of death in T2DM patients.
Use of Antiplatelet Agents for Primary and Secondary Prevention of Cardiovascular Disease Amongst Type 2 Diabetic Patients

Background. A retrospective observational study was conducted to study the use of antiplatelet agents for primary and secondary prevention of cardiovascular disease among hospitalized type 2 diabetes mellitus patients. Method. A total of 355 patients were included in the study. The compliance with the American Diabetes Association recommendation on the use of antiplatelet therapy for prevention of cardiovascular disease was studied. Results. For the primary prevention group, type 2 diabetes mellitus, patients with known dyslipidemia were more likely to receive antiplatelet therapy than those without dyslipidemia (P = 0.023). The rate of adherence to the American Diabetes Association recommendations on the use of antiplatelet therapy for secondary prevention of cardiovascular disease was higher than for primary prevention of cardiovascular disease (P = 0.001). Conclusion. In conclusion, many of the eligible patients still do not receive antiplatelet therapy, particularly in primary prevention of cardiovascular disease. Measures should be taken to ensure that type 2 diabetes mellitus patients receive the antiplatelet therapy and hence prevent macrovascular complications.
Vertebral Endplate Defect as Initiating Factor in Intervertebral Disc Degeneration: Strong Association Between Endplate Defect and Disc Degeneration in the General Population

Study Design. Cross-sectional study of spine magnetic resonance in a population, predominantly female, sample. Objective. To determine the relationship between vertebral endplate defect and intervertebral disc degeneration (DD) in general population. Summary of Background Data. Precise understanding of the mechanisms leading to DD development is lacking. In a degenerating disc, mechanical and structural changes lead to further worsening of disc integrity. Increasing attention has been paid to vertebral endplate defects as having a possible role in the etiopathogenesis of DD. Methods. The study population comprised 831 twin volunteers from TwinsUK (mean age 54 ± 8 yr, 95.8% female). Lumbar T2-weighted magnetic resonance images were coded for endplate defects from 8310 endplates into six grades. Total endplate score (TEP score) was achieved by summing both endplate defect grades from the same disc level. DD was evaluated using two different classifications; Pfirrmann grading, and a quantitative trait for DD based on a 4-point grading system. Multivariable regression analysis was used to determine relationships between the traits of interest and the known risk factors for DD, age, and body mass index (BMI). A receiver operator curve for TEP score predicting DD was generated, and survival analysis paired with Cox proportional hazards models analysis performed. Results. There was statistically significant association between DD and age and BMI. These associations lost significance when TEP score was included as predictor in multivariable model. TEP score was strongly and independently associated at every lumbar disc level with DD (Pfirmann P⩽0.001; 4-point grading systems P < 1e-16). A cut-off point score of 5 for TEP score was found above which there was a higher DD prevalence. Across all age subgroups, probabilities of having DD were significantly increased in those considered TEP score positive (≥5). Conclusion. Our large, population-based study has shown that endplate defect was strongly and independently associated with DD at every lumbar disc level. These results provide a mechanism by which increasing age and BMI predispose to DD. Level of Evidence: 2
Patient-Reported Outcomes and Costs Associated With Revision Surgery for Degenerative Cervical Spine Diseases

Study Design. A retrospective review of a prospective database. Objective. The aim of this study was to determine cost and outcomes of revision cervical spine surgery. Summary of Background Data. Revision rates for cervical spine surgery are steadily increasing. It is important to counsel patients on expected results following a revision procedure. However, outcomes and cost of these procedures are poorly defined in the literature. Methods. Patients undergoing revision cervical spine surgery at a single institution were included between October 2010 and January 2016 in a prospective registry database. Patients were divided into three cohorts depending on their etiology for revision, including recurrent disease, pseudoarthrosis, or adjacent segment disease. Patient-reported outcomes (PROs), including Neck Disability Index (NDI), EuroQol-5D (EQ-5D), modified Japanese Orthopaedic Association (mJOA) score, numeric rating scale-neck pain (NRS-NP), and numeric rating scale-arm pain (NRS-AP), were measured at baseline and 12 months following revision surgery. Mean costs at 12 months following revision surgery were also calculated. Satisfaction was determined by the NASS patient satisfaction index. Variables were compared using Student t test. Results. A total of 115 patients underwent cervical revision surgery for recurrent disease (n = 21), pseudoarthrosis (n = 45), and adjacent segment disease (n = 49). There was significant improvement in all patient-reported outcomes at 12 months following surgery regardless of etiology (P < 0.0001). Total cost of revision surgery ranged between 21,294 ± 8614 and 23,914 ± 15,396 depending on pathology. No significant differences were seen between costs among different revision groups (P = 0.53). Satisfaction was met in 75.5% to 85.7% (P = 0.21) of patients depending on the etiology of the revision need. Complication rates were between 4% and 9%. Conclusion. This is one of the first studies to determine costs and outcome measures in the setting of cervical spine revision surgery. On the basis of our analysis, a majority of patients can expect to receive some benefit by 12 months and are satisfied with their procedure. Level of Evidence: 4
Diagnosis of Mercurial Teeth in a Possible Case of Congenital Syphilis and Tuberculosis in a 19th Century Child Skeleton

Without the presence of “caries sicca,” “sabre shins,” and nodes/expansion of the long bones with superficial cavitation, differential diagnosis of venereal syphilis and tuberculosis (TB) may be difficult as various infections produce similar responses. However, congenital syphilis has distinctive features facilitating a diagnosis. A case study of remains of a juvenile European settler (probably male, 8–10 years old) (B70) buried in the 19th century and excavated in 2000 from the cemetery of the Anglican Church of St. Marys in South Australia is presented. B70 demonstrated that the two diseases might have been present in the same individual, congenital syphilis and TB. Widespread destruction of vertebral bodies and kyphosis-related rib deformations indicate advanced TB. Severe dental hypoplasia is limited to permanent incisors and first molars; there is pitting on the palate, periosteal reaction on the skull vault, and thinned clavicles. Dental signs are not limited to “screwdriver” central incisors and mulberry molars. Apical portions of the crowns of permanent upper, lower, central, and lateral incisors have multiple hypoplastic-disorganized defects; deciduous canines have severely hypoplastic crowns while possibly hypoplastic occlusal surfaces of lower deciduous second molars are largely destroyed by extensive caries. These dental abnormalities resemble teeth affected by mercurial treatment in congenital syphilitic patients as described by Hutchinson.
Supramalleolar Osteotomy for Tibiotalar Varus Malalignment

Malalignment can result in the development of osteoarthritis in the ankle joint whether the deformity is of primary or secondary origin. In either case, there is an altered load distribution across the joint that compromises joint functionality and interferes with the normal cartilage metabolism. In a varus deformity of the ankle with medial degenerative changes, a supramalleolar osteotomy restores the alignment of the hindfoot. Two approaches have been described to correct coronal plane deformity in the ankle joint: a lateral closing-wedge and a medial opening-wedge osteotomy. Good results have been reported for several indications. In this paper, we describe our experience with reconstruction of the varus malaligned ankle joint by means of a supramalleolar osteotomy.
The Adequacy of Privacy: the European Union Data Protection Directive and the North American Response

The recently passed European Directive on the Protection of Personal Data aims to harmonize European data protection law at a higher level of protection than exists now. It represents a European consensus on a standard for personal privacy and a model for countries without data protection laws. The protracted process for agreement and ratification, however, has produced a document with many derogations and ambiguities, reflecting the wider moves towards ''subsidiarity'' within the European Union. Of concern to North America is the stipulation that transborder data flow may not be permitted unless the receiving country can demonstrate an ''adequate'' level of protection. While the process through which this provision will be interpreted and applied is so far found to be complicated and unclear, nevertheless European authorities will be reluctant to tolerate ''data havens,'' a fact that should concern North American business that relies on the unimpeded flows of personal data from and to Europe. Neither Can.
Methylphenidate transdermal system for the treatment of attention-deficit/hyperactivity disorder

The methylphenidate transdermal system (MTS) is the only nonoral medication approved by the US FDA for treating the symptoms of attention-deficit/hyperactivity disorder (ADHD). MTS patches deliver methylphenidate through the skin directly into the bloodstream, largely circumventing the first-pass metabolism of the GI tract and liver that occurs with orally administered methylphenidate. Clinical studies in school-aged children have shown MTS to be well tolerated and effective in the treatment of ADHD. Adverse effects most commonly seen in clinical studies are consistent with those seen with the use of other methylphenidate products and include decreased appetite, insomnia, headache, nausea, vomiting, anorexia and weight loss. When worn for the recommended 9 h, MTS demonstrated significant reductions in the core symptoms of ADHD from 2 through 12 h post-application. The methylphenidate transdermal system (MTS, (Daytrana ® ), Shire US Inc., PA, USA) is a patch that delivers racemic methylpheni- date (MPH) through the skin directly into the bloodstream. MTS was approved by the US FDA in 2006 for the treatment of attention- deficit/hyperactivity disorder (ADHD) in
A blood sugar tolerance test

Various objections may be made to methods now in vogue for sugar tolerance determinations which depend on the appearance of sugar in the urine. Much more reliable, instructive and delicate results can be obtained by a study of the hyperglycemic response of the blood to ingested sugar. When pure glucose is administered in amounts equal to 13/4 gm. per kgm. body weight in 40 per cent. aqueous solution to fasting patients, alimental absorption is so regular that a normal hyperglycemic curve can be established. The blood sugar reattains its fasting level 11/2 to 2 hours after the sugar is taken. The oral method of administration is therefore much more certain than has been supposed. For clinical purposes the test is carried out by first determining by Epstein's modification of the Lewis and Benedict method, the blood sugar of a patient who has fasted over night, then administering the sugar drink as prepared above, with the addition of the juice of a lemon and again determining the blood sugar at the end of two hours. In normal subjects the blood sugar has by this time returned to its fasting level. If hyperglycemia still persists, the blood sugar tolerance is lowered. This is the simplest form to which the technique is reducible. We prefer to make several half hourly or hourly observations of the blood sugar following glucose ingestion also to determine the presence and amount of sugar voided in the urine during these determinations and in the complete twen ty-four- hour specimen. Glycosuria, which is normally absent under the conditions of the test, is not a necessary accompaniment of decreased tolerance. A normal blood sugar curve accompanied by glycosuria usually indicates renal diabetes. Mie have also found this test useful in the diagnosis of incipient diabetes.
A case of vaginal clear cell adenocarcinoma complicated with congenital anomalies of the genitourinary tract and metanephric remnant without prenatal diethylstilbestrol exposure

Vaginal clear cell adenocarcinoma (CCA) is well known to be associated with prenatal diethylstilbestrol exposure. We present a vaginal CCA with congenital anomalies of the genitourinary tract without prenatal diethylstilbestrol exposure. A 54‐year‐old woman complained of a 3‐month history of genital bleeding. The examination revealed CCA at the anterior vagina and congenital anomalies. An anterior pelvic exenteration was performed. Macroscopically, bicornuate uterus, vaginal septum and left ureteral agenesis were found. Microscopically, vaginal CCA coexisted with adenosis and both metanephric and mesonephric remnants. The vaginal CCA was supposed to derive from coexisting adenosis. The adenosis was also supposed to occur as a congenital basis, together with genitourinary tract anomalies. Relations between congenital anomalies of the genitourinary tract and vaginal adenocarcinoma were suspected, resultantly.
Inside self‐regulation: peer review (visitatie) by Dutch medical specialists

To deepen our insight into the Dutch system of visitatie, a doctors‐led and ‐owned external peer review mechanism through site visits, a process evaluation was performed. The study focussed on the practice‐specific recommendations for improvement as the measurable outcome of the peer review process, the attitude of medical specialists towards visitatie, and towards the recommendations. Medical specialists’ positive attitudes towards visitatie hold promise for the implementation of the recommendations for improvement, an essential final step in the process. In order to achieve improvements tailor made implementation strategies need to be offered. Specialty societies and hospital managers could play a role in facilitating improvement.
Development of a Chinese Version of the Oswestry Disability Index Version 2.1

Study Design. Cross-cultural adaptation and cross-sectional psychometric testing in a convenience sample of patients with low back pain. Objective. To translate and culturally adapt the Oswestry Disability Index version 2.1 (ODI 2.1) into a Mandarin Chinese version and to assess its reliability and validity. Summary of Background Data. The Chinese ODI 2.1 has not been developed and validated. Methods. The ODI 2.1 was translated and culturally adapted to the Chinese version. The validity of the translated Chinese version was assessed by examining the relationship between the ODI and other well-known measures. Test–retest reliability was examined in 52 of these patients, who completed a second questionnaire within 1 week. Results. Internal consistency of the ODI 2.1 was excellent with Cronbach’s &agr; = 0.903. The intraclass correlation coefficient of test–retest reliability was 0.89. The minimal detectable change was 12.8. The convergent validity of the Chinese ODI is supported by its high correlation with other physical functional status measures (Roland Morris Disability Questionnaire and SF-36 physical functioning subscale, r = 0.76 and −0.75, respectively), and moderate correlation with other measures (Visual Analogue Scale, r = 0.68) and certain SF-36 subscales (role-physical, bodily pain, and social functioning, r range: −0.49 to −0.57). As expected, the ODI was least correlated with nonfunctional measures (SF-36 mental subscale and role-emotional subscale, r = −0.25 and −0.33, respectively). Conclusion. The results of this study indicate that the Chinese version of the ODI 2.1 is a reliable and valid instrument for the measurement of functional status in patients with low back pain.
Nursing Core Competencies Needed in the Fields of Nursing Practice for Graduates in Nursing

Purpose: This study was done to provide information on issues of nursing core competencies needed in the fields of nursing practice for graduates in nursing, from the perspective of nursing managers, and to make suggestion for improving nursing education programs. Methods: Ten nursing managers participated in this study. They were in charge of clinical nursing education in the fields of nursing practice. Data were collected using focus group interviews and analyzed with the content analysis methodology of Downe - Wamboldt's. Results: Six types of nursing core competency - therapeutic nursing competency, professional nursing competency, administrative nursing competency, humanistic nursing competency, relational nursing competency, and personal nursing competency - were identified as nursing core competencies needed in the fields of nursing practice for graduates in nursing. Conclusion: Results of the study show important evidence for decision-making about nursing curriculum revision based on nursing core competency, both in the classroom and in nursing practice areas. These results should contribute to the development of evaluation indicators for nursing students or new nurses. Further research is required to measure degree of nursing core competency in graduates of nursing and to identify the effect of competency-based education for improving nursing core competency.
Alteration of subjective feelings in football players undertaking their usual training and match schedule during the Ramadan fast

Abstract Eighty-seven players (54 fasting players, 33 non-fasting players) who carried out their club's scheduled training and competitive matches completed the daily questionnaire before and during Ramadan. Fasting players trained on average 11 h after their last food and drink. While fasting players reported that they were slightly less ready to train during the Ramadan fast than in the period before Ramadan, there was no increase in their perceived effort during training or in training difficulty compared with their ratings before Ramadan, or with those of the non-fasting group during Ramadan. The fasting players were marginally more thirsty, hungry and tired, and slightly less able to concentrate before training during Ramadan than in the pre-Ramadan period. Before Ramadan, both groups averaged more than 9 h sleep each night. The non-fasting players recorded that they had about 105 min less sleep per night during the first week of Ramadan, before reverting back to their pre-Ramadan amount of sleep. The fasting group consistently reported having about 1 h less sleep per night throughout Ramadan, but neither group appeared to find sleep quality to have altered. In the first 2 weeks after Ramadan, the modest changes reported by the fasting players reverted back to their pre-Ramadan values.
Heart rate and metabolic responses to moderate-intensity aerobic exercise: A comparison of graded walking and ungraded jogging at a constant perceived exertion

Abstract In this study, we assessed how ungraded jogging and graded walking at the same rating of perceived exertion (RPE) affect heart rate and oxygen consumption ([Vdot]O2). Twenty untrained participants completed a treadmill test to determine peak [Vdot]O2 (mean = 40.3 ± 6.3 ml · kg−1 · min−1). Participants completed separate 30-min trials of moderate exercise (RPE of 13 on the Borg 6–20 scale) in random order on the treadmill: graded walking and ungraded jogging. Treadmill speed or grade was adjusted throughout the trial by the experimenter based on participant responses to maintain an RPE of 13. The jogging trial produced a significantly higher heart rate (161 ± 18 vs. 142 ± 24 beats · min−1) and [Vdot]O2 (7.4 ± 1.8 vs. 5.8 ± 1.5 METs) (P < 0.01) than the walking trial. Treadmill grade decreased significantly during the walking trial (11.1 ± 2.3% to 10.0 ± 2.2%; P < 0.01), but treadmill speed did not change significantly during the jogging trial (5.2 ± 1.0 miles · h−1 to 5.0 ± 0.9 miles · h−1) (P > 0.05), in an effort to maintain constant RPE. These findings provide evidence that similar perceptions of effort during graded walking and ungraded jogging do not produce similar cardiovascular and metabolic responses. The results indicate that, for a given prescribed perceived effort, jogging provides a greater stimulus for fitness benefits and caloric expenditure.
Comparative evaluation of dimensional stability of three types of interocclusal recording materials: An in vitro study

Statement of Problem : Interocclusal recording materials should have good dimensional stability for precise articulation. Purpose :The aim of this in vitro study was to evaluate and compare the dimensional stability of three types of interocclussal recording materials at various time intervals. Materials and Methods : The materials used in the study were polyvinylsiloxane (Virtual), zinc oxide eugenol paste (Superbite) and Bite registration wax (Alumax). The test was carried out using a mold of the American Dental Association (ADA) specification No. 19. A total of 30 samples were made with each group consisting of ten samples. The samples were measured using an optical microscope with a micrometer provision. The measurements were made at time intervals of 1, 24, 48 and 72 hrs. Results : Five readings were taken for each sample at each time interval and the mean was considered to measure the dimensional change by comparing with that of the original measurement in the die. The results obtained were statistically analyzed using a one-way analysis of variance (ANOVA) and Tukey-(Honestly Significant Differences) HSD test. The mean percentage dimensional change at various time intervals: I) Group A 1 h-0.22%, 24 h-0.48%, 48 h-0.66%, 72 h-0.79%; II) Group B 1 h-0.58%, 24 h-0.93%, 48 h-1.23%, 72 h-1.46% III) Group C 1 h-0.44%, 24 h-0.60%, 48 h-0.77%, 72 h-1.07%, respectively. Group A was dimensionally the most stable of the three groups followed by Group C and then Group B. Conclusion : Dimensional stability is influenced by both the material and time factors and is found to decrease as the time factor increased. Polyvinylsiloxane (Virtual, Group A) was dimensionally the most stable followed by zinc oxide eugenol paste (Superbite, Group C) and then Bite registration wax (Alumax, Group B).