Miracle-dz/UniFAR-FTUs huggingface dataset:
Nuss Procedure and Factor VII Deficiency: A Case Report.

A 19 year-old boy admitted with pain and discoloration on his chest wall 18 months after a Nuss procedure performed for pectus excavatum deformity. His physical examination revealed that this skin lesion was an ecchymosis. We diagnosed a very rare bleeding disorder due to Factor VII deficiency which is a recessively inherited coagulation disorder where even spontaneous bleedings may be seen. We aimed to discuss the management of the patient, if it had been diagnosed preoperatively and the preoperative preparation before the bar removal.
Gene delivery systems for gene therapy in tissue engineering and central nervous system applications

The present review aims to describe the potential applications of gene delivery systems to tissue engineering and central nervous system diseases. Some key experimental work has been done with interesting results, but the subject is far from being fully explored. The combined approach of gene therapy and material science has a huge potential to improve the therapeutic approaches now available for a wide range of medical applications. Focus is given to this multidisciplinary strategy in neurodegenerative pathologies, where the use of polymeric matrices as gene carriers might make a crucial difference.
Alternative Impression Technique for a Speech-Aid Prosthesis

Objective: Prosthetic treatment for speech disorders attributable to surgically acquired soft palate defects are introduced. Case: A patient who underwent soft palate resection for cancer is presented. The resected portion of the soft palate was confined to the posterior segments. A prosthesis with a speech bulb was adapted to the patient. Conclusion: Excellent restoration of speech and improvement of velopharyngeal function was achieved following placement of the special prosthesis.
Adapting Reading Methodology to Aboriginal Children

It is quite likely that at the start of a teaching career at an Aboriginal school, a teacher would know how to teach reading. He would have received the theoretical background at college or university, and applied this knowledge with varying degrees of success at practice-teaching sessions and possibly with increasing success at an urban school. Therefore, when an obviously talented teacher finds that previously used strategies simply do not work, and even his knowledge of how to cope with disadvantaged and remedial children seems to be of no use, it is time to look a little deeper into what motivates his pupils.
Consumers´ Information Search Behavior on Wholesome Nutrition and their Attitudes towards Health Products; A Field Study from Eskisehir, Turkey

This survey intends to find out the attitudes of the consumers towards health products such as organic food, healthy foodstuffs and their information seeking behavior on wholesome nutrition. A survey is applied to 480 respondents selected via stratified sampling from Eski? ehir, a city of Turkey with 700.000 inhabitants where 470 of the responses are found eligible. The respondents are required to answer 50 questions of which five are related to demographic characteristics of these respondents. The rest 45 are statements which are designed to reflect the behavior of these people. The study consists of five parts. The first part is an introduction where the scope and the purpose of the study are concisely stated. The second part relates to the theoretical background of the subject matter and the prior researches carried out so far. The third part deals with research methodology, basic premises and hypotheses attached to these premises. Research model and analyses take place in this section. Theoretical framework is built and a variable name is assigned to each of the question asked or proposition forwarded to the respondents of this survey. 42 statements or propositions given to the respondents are placed on a five-point Likert scale. Three questions are on an ordinal scale reflecting the most-used information sources of the respondents. The remaining five questions about demographic traits as age, gender, occupation, educational level and monthly income are placed either on a nominal or ratio scale with respect to the nature of the trait. Ten research hypotheses are formulated in this section. The fourth part mainly deals with the results of the hypothesis tests and a factor analysis is applied to the data on hand. Here exploratory factor analysis reduces 42 variables to eight basic components as: " Nutritional knowledge, nutritional labels and health claims; care for health products; consumer positive and negative attitudes toward organic foods; fast-food involvement; prior product knowledge; e-health information search; information search behavior; and system beaters". In addition non-parametric bivariate analysis in terms of Chi-Square is applied to test the hypotheses formulated in this respect. The fifth part is the conclusion where findings of this survey is listed.
Maxillary Arch Dimensions in Bilateral Cleft Lip and Palate from Birth until Four Years of Age in Boys

Objective: To describe the development of maxillary arch dimensions in children with bilateral cleft lip and palate (BCLP) during the first 4 years of life and to compare it with that in noncleft children. Design: This was a retrospective, mixed-longitudinal study. Setting: The study was conducted at the Cleft Palate Center of the University Hospital of Nijmegen. Subjects: The sample consisted of 26 boys with BCLP who were born between 1976 and 1990 and treated at the University Hospital of Nijmegen. Data for a control group of 34 noncleft boys were collected at the University Hospital of Amsterdam. Method: Palatal arch dimensions were digitized on dental casts. A comparison between BCLP and noncleft dimensions was made at fixed time intervals. Results: At birth, anterior and posterior arch widths as well as arch depths were significantly larger in children with BCLP. After 7 months (lip closure), anterior arch width and arch depth diminished considerably in the cleft group. After 12 months (palatoplasty), a slight decrease in posterior arch width was observed, and arch depths showed slight catch-up growth. At 4 years of age, anterior arch width was significantly narrower and anterior arch depth was shorter in children with BCLP than in control subjects. Posterior arch width was significantly wider. Conclusions: During the first 4 years of life, maxillary arch dimensions in children with BCLP show a unique development that is significantly different from that in noncleft children.
Perceptual Evaluation of Speech and Velopharyngeal Function in Children with and without Cleft Palate and the Relationship to Nasal Airflow Patterns

Objectives The aim was to study the relationship between perceptual evaluation of speech variables related to velopharyngeal function and the pattern of nasal airflow during the velopharyngeal closing phase in speech in children with and without cleft palate. Participants Fourteen children with cleft lip and palate or cleft palate only and 15 controls aged 7 and 10 years. All were native Swedish speakers. Method Three experienced listeners performed a blinded perceptual speech evaluation. Nasal airflow was transduced with a pneumotachograph attached to a nasal mask. The duration from peak to 5% nasal airflow, maximum flow declination rate, and nasal airflow at selected points in time during the transition from nasal to stop consonants in bilabial and velar articulatory positions in sentences were estimated. The analysis was focused on the perceptual ratings of “velopharyngeal function” and “hypernasality. ” Results A strong association was found between ratings of “velopharyngeal function” and “hypernasality” and the pattern of nasal airflow during the bilabial nasal-to-stop combination /mp/. Both the sensitivity and specificity were 1.00 for the bilabial temporal airflow measure in relation to ratings of “velopharyngeal function. ” The nasal airflow rate during /p/ in /mp/ had a sensitivity of 1.00 and specificity of 0.92 to 0.96 in relation to ratings of “hypernasality. ” Conclusion Assessment of the nasal airflow dynamics during the velopharyngeal closing phase in speech presents quantitative, objective data that appear to distinguish between perceptually normal and deviant velopharyngeal function with high sensitivity and specificity.
Evaluation of sociocultural competency training in enhancing self-efficacy among immigrant and Canadian-born health sciences trainees

The study was to investigate the effect iveness of Sociocul tural Compe tency Training ( S C C T ) as an intervention in enhancing self-eff icacy among trainees in the health care profession. The purposes o f t he study were threefold: (a) to evaluate the effect iveness o f the training in enhanc ing the trainees' self-eff icacy and behavioural performance; (b) to examine their personal exper iences in the learning o f the sociocultural competenc ies , and (c) to identify the factors that contribute to effective outcomes. A sample of 84 participants in the Health Sc iences program at the Vancouve r Communi ty Co l lege w a s recruited. There were 26 local born Canad ians and 32 immigrants in the exper imental group, whereas 11 local born Canad ians and 15 immigrants were in the control group. Exper imental group participants took part in an 18hour training over a 6-week period as part of their regular Human Relat ions Ski l ls course curr iculum. The control group also took the s a m e training course after posttest data col lection. Th is study used both quantitative and qualitative methods. Sel f -ef f icacy and behavioural performance were a s s e s s e d quantitatively by the results from the Genera l Sel f -Ef f icacy Sca le ( G S E ) , Situational Soc ia l Avo idance S c a l e ( S S A ) , Soc ia l Sel f -Ef f icacy Sca le ( S S E ) , and Interpersonal Ski l ls Check l is t ( ISC-33). Quali tat ive data was col lected through written feedback from 28
Compliance, titration and side effects of oral appliances in snoring and obstructive sleep apnea patients

Long-term compliance, titration modalities and side effects of oral appliances (OAs), used for the management of snoring and obstructive sleep apnea (OSA), have been investigated in a large sample of subjects. The majority of patients were compliant with OA treatment (64.1%) after a mean period of 5.7 years. The most frequent reasons why patients discontinued wear were uncomfortable (44.4%), had little or no effect (33.6%), or switched to nasal Continuous Positive Airway Pressure (23.3%). Side effects, such as dry mouth and tooth and/or jaw discomfort, were more frequent and more severe in non-compliant subjects (p<0.05). Subjects who were compliant with OA therapy reported long periods of use, a lower perception of side effects and a greater decrease in snoring as compared to the non-compliant. In order to improve efficacy, an apnea monitor revealed a good correlation of 0.805 with polysomnography. In the calculation of a receiver operating characteristic curve at a threshold value of apnea and hypopnea index (AHI) of 10/hour, the area under the curve was 0.915. The tested snoring monitor (based on a nasal cannula pressure transducer), when compared to a noise level meter, presented a significant correlation of 0.77 and its correlation with the AHI was r = 0.47 for patients with an AHI smaller than 30/h. These instruments are probably useful tools to improve the titration of OAs and consequently increase OA effectiveness. Over a mean period of 7.3 years, OAs induce changes in the dental structures that appear to be progressive over time when measured by cephalometric and study model analyses. These changes were expressed as a decrease in overbite and overjet of 2.8 and 2.6 mm respectively, retroclination of the maxillary incisors and proclination of the mandibular incisors. Interestingly, for half of those patients, the changes were considered favorable for their occlusion. Favorable changes were also correlated with a greater initial overjet. Since OSA is a life-threatening disease, OA therapy should be maximized in terms of compliance and efficacy and override the concept that only maintenance of a baseline occlusion is important. Long-term follow-up should be encouraged in all OA clinical protocols.
Right Heart Function during Left Ventricular Assistance in an Open-Chest Porcine Model of Acute Right Heart Failure

Changes in the right ventricular function measured with a thermodilution ejection fraction catheter have been recorded in open-chest normal pigs and pigs with acute right heart failure (RVF) undergoing left ventricular assistance with a pneumatic-sactype device (LVAD). To produce acute right heart failure, 5 pigs underwent ligation of the right ventricular free wall coronary arteries. Compared with normal pigs, cardiac output in ligated pigs fell by 21% (7.5 ± 0.5 vs 9.5 ± 1.2 L/min; p < 0.05) and the right ventricular end diastolic pressure rose (11.4 ± 2.6 vs 5.7 ± 3.6 vs mmHg: p <0.05). With the left ventricular assist device connected, the right atrial pressure was increased to 3, 5, 7, 10 and 12 mmHg by volume loading while maintaining the haematocrit at 35 ± 6%. The right ventricular stroke work index (RVSWI) increased with volume loading in normal pigs. In RVF pigs, RVSWI increased significantly with the LVAD (59.2 ± 5.8 vs 23.5 ± 7.8 mmHg ml/ min/kg, p<0.01 ), approaching that of normal pigs (62.3 ± 4.8 mmHg ml/min/kg). Similar changes were observed in the cardiac output and right ventricular stroke volume. These results show that, in this model of open-chest, mild, acute right heart failure, left ventricular assistance allows right ventricular function to return to normal, despite volume overloading, by decreasing right ventricular after load and increasing right ventricular compliance (Int J Artif Organs 1994; 17: 224-9)
Syringe drivers

Palliative care in general practice has been compared to standing at a bus stop. You may have a long wait for a palliative care patient to arrive, but when they do they often come in gatherings of two or three. This can lead to the knowledge and expertise obtained in recent palliative care experience to dissipate while waiting for the next patient. An area of specific knowledge within palliative care that causes a lot of concern for GPs is the use of syringe drivers (also known as continuous subcutaneous infusions). A syringe driver is a small, portable battery-operated device that administers medicines subcutaneously over a selected time period, usually 24 hours. This article looks at indications for considering use of a syringe driver, practicalities of use and common medications and doses used in a syringe driver.
Bioactive Hydrogel-Filament Scaffolds for Nerve Repair and Regeneration

The design of novel biomaterials is crucial for the advancement of tissue engineering in nerve regeneration. In this study we developed and evaluated novel biosynthetic scaffolds comprising collagen crosslinked with a terpolymer of poly(N-isopropylacrylamide) (PNiPAAm) as conduits for nerve growth. These collagen-terpolymer (collagen-TERP) scaffolds grafted with the laminin pentapeptide YIGSR were previously used as corneal substitutes in pigs and demonstrated enhanced nerve regeneration compared to allografts. The purpose of this project was to enhance neuronal growth on the collagen-TERP scaffolds through the incorporation of supporting fibers. Neuronal growth on these matrices was assessed in vitro using isolated dorsal root ganglia as a nerve source. Statistical significance was assessed using a one-way ANOVA. The incorporation of fibers into the collagen-TERP scaffolds produced a significant increase in neurite extension (p<0.05). The growth habit of the nerves varied with the type of fiber and included directional growth of the neurites along the surface of certain fiber types. Furthermore, the presence of fibers in the collagen-TERP scaffolds appeared to influence neurite morphology and function; neurites grown on fibers-incorporated collagen-TERP scaffolds expressed higher levels of Na channels compared to the scaffolds without fiber. Overall, our results suggest that incorporation of supporting fibers enhanced neurite outgrowth and that surface properties of the scaffold play an important role in promoting and guiding nerve regeneration. More importantly, this study demonstrates the potential value of tissue engineered collagen-TERP hybrid scaffolds as conduits in peripheral nerve repair.
Presurgical Nasoalveolar Molding in Infants with Cleft Lip and Palate

Presurgical infant orthopedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. In this paper, we present a paradigm shift from the traditional methods of presurgical infant orthopedics. Some of the problems that the traditional approach failed to address include the deformity of the nasal cartilages in unilateral as well as bilateral clefts of the lip and palate and the deficiency of columella tissue in infants with bilateral clefts. The nasoalveolar molding (NAM) technique we describe uses acrylic nasal stents attached to the vestibular shield of an oral molding plate to mold the nasal alar cartilages into normal form and position during the neonatal period. This technique takes advantage of the malleability of Immature cartilage and its ability to maintain a permanent correction of its form. In addition, we demonstrate the ability to nonsurgically construct the columella through the application of tissue expansion principles. This construction is performed by gradual elongation of the nasal stents and the application of tissue-expanding elastic forces that are applied to the prolabium. Use of the NAM technique has eliminated surgical columella reconstruction and the resultant scar tissue from the standard of care in this cleft palate center.
Mandibular Bone Graft Material for Reconstruction of Alveolar Cleft Defects: Long-Term Results

Objective: To analyze the long-term effect of mandibular bone as donor material in bone grafting of the alveolar process defect in patients with unilateral cleft lip and palate (UCLP), compared with iliac crest cancellous bone. Method: During a 7-year period, 101 UCLP patients were bone grafted, 57 cases with iliac crest cancellous bone and 44 with mandibular symphyseal bone. The long-term results with an observation time of more than 4 years were analyzed with respect to marginal bone level and dental and gingival condition in the grafted area. Complications were recorded. Results: The bone level in the grafted area was satisfactory in both groups. Impaction of cleft-side canines was found in 35% of the patients in both groups. Patients with agenesis of the cleft side lateral incisor had significantly more impacted canines, compared with patients with a cleft-side lateral situated in the lesser maxillary segment, probably due to the fact that the lateral incisors help in guiding the canine down through the grafted area. The number of complications was scarce, although both groups demonstrated some gingival retraction with a longer crown length at the cleft side central incisor. Conclusion: The findings of this study have changed our strategy in bone grafting. Timing of orthodontic treatment and bone grafting has been more varied depending on the position and presence of teeth in the cleft area. Bone grafting of the alveolar process is not just a local treatment of a bony defect, but in respect to the burden of treatment, bone grafting of the alveolar process has to be planned in accordance with orthodontic treatment and maxillofacial growth.
Three-Dimensional Analysis of Cleft Palate Topology in Newborn Infants with Reference to the Cranial Skeleton

Objective: To describe a method of determining the three-dimensional topology of the palatal crest relative to a reproducible anthropomorphic coordinate system in newborn infants with unilateral cleft palate. For this purpose, physical models of the maxilla and face were analyzed by computer morphometry. Design: The study was limited to infants referred to the craniofacial center during the first 11 days after birth. Setting: The study was performed at a craniofacial center servicing a large geographic area. Participants: The method was applied to 12 infants with unilateral cleft lip, alveolus, and palate (eight patients with left-side clefts and four with right-side clefts). Main Outcome Measures: The three-dimensional topology of the palatal crest referenced to an anthropometric coordinate system was the primary outcome measure. The anthropometric reference system is defined by the tragus points and the midpoint of a line connecting the endocanthia. Results: The topology of the maxillary crests of the patients was characterized by considerable variability. The center of the premaxilla as defined by the attachment of the frenulum was frequently displaced by several millimeters from the midsagittal plane. The displacement was to the left in infants with right-side clefts and to the right in infants with left-side clefts. The premaxilla can be rotated by more than 308 relative to the normal position. No significant retroposition of the minor segment as determined by the location of the tuber points was found. Several morphometric anomalies were found to be correlated linearly. Conclusions: We propose that the morphologic deviations are in part caused by the neuromotor activity of the tongue and of the interrupted M. orbicularis oris. The data can serve as the starting point for a longitudinal study of craniofacial development in children with cleft palate and for studies on the efficacy of different therapeutic approaches.
EFFECTS OF RURAL AND URBAN POPULATION ON HEALTH CARE EXPENDITURE: CASE OF CHINA AND INDIA

This paper examines the effects of population at rural and urban on health care expenditure in the case of China and India. Total population in China and India increased from year to year, as in 1970 total population is 5.78 million to 1.21 billion in 2015 for China and 5.54 million and increased to 1.25 billion for India. Projection of population established in 2015 predict that the total population will keep growing until at least 2050, reaching an estimated 8 billion people in 2024, and 9 billion people in 2024 and 9 billion by 2040. As the demographic transition follows its course worldwide, the population will age significantly, with most countries outside Africa trending towards a rectangular age pyramid. But total population in urban is higher than population in rural. For urban population they will spend with their own money for healthcare or out of pocket expenditure. This paper is estimate the comparison between population in rural and urban on healthcare expenditure in case of China and India. By using bound testing approach to cointegration and error correction model, developed within an autoregressive distributed lag (ARDL) framework developed by Pesaran et al. (1999) and data cover from period 19702016, we investigate whether a long-run equilibrium relationship exists between population and health care expenditure. Using this approach, the expected result for long run relationship between population in rural and urban on health care expenditure is positive but the healthcare expenditure for urban population is higher than rural population.