Miracle-dz/UniFAR-FTUs huggingface dataset:
Obstetricians' attitudes and practices of life support for extremely premature low birth weight infants in El Salvador

Background: The increasing availability of costly life-support technologies in developing countries raises questions about the utility of resuscitation and intensive care for extremely premature infants. Objective: To characterize obstetricians’ attitudes and resuscitation practices for preterm infants in El Salvador. Design/Methods: Surveys (n = 214) were mailed to Salvadoran perinatal providers in 2000, and 100 more were distributed at a Latin American obstetrics and gynecology conference in December 2000. Survey questions covered counseling practices, resuscitation thresholds for prematurity, attitudes on life support, and demographics. Results: Of 111 Salvadoran respondents, more providers counsel parents antenatally (41% at 25 wks to 58% at 29 wks) as gestational age increased. Median thresholds for resuscitation were 26 weeks for intubation and ventilation and 27 weeks for cardiac massage or pharmacologic resuscitation, and 1000 grams for each of these interventions. Seventy-two percent of respondents would use all interventions to save life regardless of anticipated outcome, a stance correlated with religious activity (p = 0.03). Decisions to limit resuscitation were influenced by congenital anomalies (62%) more than parental wishes (28%), infant pain (21%) and moral or religious considerations (27%). Older obstetricians were more likely to withdraw support from an extremely premature infant with perinatal HIV exposure (p = 0.006), but not with severe intraventricular hemorrhage or a major congenital anomaly. Fifty-five percent felt their institution was “not aggressive enough” in caring for infants < 26 wks gestation. Less religious obstetricians were more likely to perceive their unit as “too aggressive. ” Over 80% believed that physicians (44%), rather than parents (15%), should make final resuscitation decisions when consensus cannot be reached. Conclusions: In El Salvador, the obstetric management of extreme prematurity is influenced by providers’ level of religious activity. The majority of obstetricians regard care in their unit as not aggressive enough, despite using higher resuscitation thresholds than in other developing countries. Local economic constraints influence resuscitation options available to obstetricians and parents of extremely premature infants.
Asociación entre la contemplación de la TV y los horarios irregulares de sueño en los niños menores de 3 años

son una parte importante de los hábitos sanos. Aunque la contemplación de la televisión (TV) se asocia con alteraciones de los horarios de sueño y con trastornos propios del sueño en los niños y adolescentes, se desconoce el efecto de la TV sobre los horarios de sueño de los lactantes y preescolares. OBJETIVO: Investigar la hipótesis de que la contemplación de la TV por parte de los lactantes y preescolares se asocia con unos horarios irregulares de las siestas y del descanso nocturno. MÉTODOS: Se emplearon datos de la National Survey on Early Childhood Health, una encuesta transversal, representativa a escala nacional, realizada sobre niños de 4 a 35 meses. El principal parámetro valorado fue si los niños tenían o no horarios irregulares en las siestas y en el descanso nocturno. El principal factor predictivo fue el número de horas diarias de contemplación de la TV. Se realizaron análisis de regresión logística de variables múltiples para diversos factores, como los datos demográficos y los parámetros de la salud mental de la madre y de las interacciones familiares, con el fin de investigar la asociación independiente de la contemplación de la TV y los horarios irregulares en las siestas y en el descanso nocturno. RESULTADOS: Se obtuvieron datos de 2.068 niños; el 34% presentaba horarios irregulares en las siestas y el 27% en el descanso nocturno. La cifra media diaria de horas de TV fue de 0,9 (intervalo de confianza [IC] del 95%, 0,8-1,0) en los niños menores de 12 meses, de 1,6 (IC del 95%, 1,4-1,8) en los niños de 12-23 meses, y de 2,3 (IC del 95%, 2,1-2,5) en los de 24-35 meses. En el modelo de regresión logística, el número de horas diarias de TV se asoció con horarios irregulares en las siestas (odds ratio [OR] = 1,09; IC del 95%, 1,01-1,18) y en el descanso nocturno (OR = 1,13; IC del 95%, 1,04-1,24). CONCLUSIONES: La contemplación de la TV en los lactantes y preescolares se asocia con horarios irregulares de sueño. Es necesario realizar más investigaciones para determinar si esta asociación es de tipo causal.
Complex chronic care: Patient, provider and organisational issues

Abstract With the ageing population and therapeutic advances in acute and chronic disease treatment, more patients are living with at least one chronic condition. The management of a patient's chronic condition is complicated by the simultaneous presence of multiple competing comorbidities and the intrapersonal and external factors that influence chronic care. The current US healthcare system is largely organised around the management of acute illness and as a result is struggling to meet the challenges of complex chronic care. These challenges require innovative strategies to improve patient care and clinical outcomes. This paper explores some of the challenges faced by patients, healthcare providers and healthcare systems, and reviews new avenues of health services research that target these challenges.
The challenges and some thinking for the intelligentization of precision guidance ATR

In recent years, with the raising of the effectiveness and importance of precision guided weapons in the modern high-technology war, the development of precision guidance system has made outstanding achievements. But because the targets, environment and mission of the precision guidance system have been changed significantly, the complexity of the battlefield environment and the uncertainty of the target characteristics bring new challenges to the development of precision guidance systems and technology. To make the missile adapt to the complex and varying battlefield environment and engage various targets accurately, the concepts of intelligent missile and the intelligentization of precise guidance system based on artificial intelligence technology are put forward. Although the concept of intelligent missile has been put forward for many years，the development of the existing precision guidance system still suffers from the lag of the capability of intelligentization. There is still no good solution to the problem of automatic target recognition and decision making in complex battlefield environment with high intelligence. It is difficult to meet the requirement to adapt to the complex and varying battlefield environment and engage various targets accurately under the fierce countermeasure conditions. Focusing on the precise guidance automatic target recognition, in this paper，the development process of the intelligent precise guidance ATR system is introduced. The challenges faced by the current precision guidance ATR system’s intellectualization is analyzed. Some superficial views on the development of the intelligent ATR are given.
Selección de vacas Jersey y Holstein durante la lactancia según características fenotípicas: producción y reproducción

Introducción: asociar las características físicas de los animales en un sistema de producción es una herramienta que permite agrupar los animales que se adaptan a las condiciones de clima, topografía y manejo, sin afectar su productividad. Objetivo: nuestro objetivo fue evaluar la relación de 17 variables físicas de 1 260 animales de las razas Holstein y Jersey; con su productividad en sistemas de producción de leche ubicados en las faldas del Volcán Poás, Alajuela Costa Rica durante los años 2013 y 2014. Metodología: las fincas evaluadas presentaron similitud en el manejo de los animales, en la parte nutricional y en el aspecto sanitario. Para tal fin, recopilamos información de la producción diaria por vaca, la producción por lactancia ajustada a 305 días, el intervalo entre partos, los días abiertos, los días post parto al primer servicio y los servicios por concepción. Resultados: la estatura, la capacidad corporal, el carácter lechero, la fortaleza y el ángulo de anca son las partes de la vaca que más influencia tienen sobre el desempeño reproductivo. La conformación de la ubre no tiene influencia en los parámetros reproductivos, no se obtuvo diferencias estadísticas entre los diferentes puntajes para las características de ubre y los parámetros reproductivos, pero si se puede mencionar tendencias en ambas razas. La ubre está asociada a la producción de leche más que las patas y pezuñas. Conclusión: los resultados de esta investigación son exploratorios, pero permiten visibilizar variables para definir un programa de selección voluntario de animales Holstein o Jersey durante el periodo de lactancia, que permita obtener animales que se adapten según las características de manejo, ambientales, nutricionales y sanitarias de cada sistema.
Las médicas, sus prácticas y el dilema con la feminidad

With the aim of studying how personal and professional life interact in young female doctors in Spain, we have analysed three groups that practice three of the most feminized specialties ‐general medicine, paediatrics, and psychiatry‐, applying a gender perspective and a group methodology. For the analysis we identify a series of categories that are present in the three groups and that in the bibliography are related with the medical practice of women. In the professionals of our study, contradictions and ambivalent feelings show up when related to their communicative style at office, to the negotiation with colleges and patients, to their position before authority and power, and to the performance of their professional roles. In the group discourse of female doctors we identify the existence of a conflict between their identity as professionals and their identity as women.
Síndrome de QT largo. El electrocardiograma de interacciones medicamentosas peligrosas

Ventricular repolarization is not always evaluated properly at the moment of adopting certain medical management and its consequences might be fatal. Electrolyte disturbances and class III antiarrhythmic drug therapies are frequent associations in daily clinical practice and constitute two factors that have great repercussions as they may modify ventricular repolarization and generate malignant ventricular arrhythmias. This case report deals with drug interactions, electrocardiographic changes and proarrhythmic effects.
Respiratory rehabilitation of patients with chronic obstructive pulmonary disease

Abstract Background Physical exercise is an important component of respiratory rehabilitation because it re-verses skeletal muscle dysfunction, a clinically important manifestation of COPD asso-ciated with reduced health-related quality of life (HRQL) and survival. However, thereis controversy regarding the components of the optimal exercise protocol. We systemat-ically evaluated and summarised randomised controlled trials (RCTs) comparing differ-ent exercise protocols for COPD patients. Methods We searched six electronic databases, congress proceedings and bibliographies of includ-ed studies without imposing language restrictions. Two reviewers independentlyscreened all records and extracted data on study samples, interventions and method-ological characteristics of included studies. Results The methodological quality of the 15 included RCTs was low to moderate. Strength ex-ercise led to larger improvements of HRQL than endurance exercise (weighted meandifference for chronic respiratory questionnaire 0.27, 95 % CI 0.02 to 0.52). Interval exer-cise seems to be of similar effectiveness compared to continuous exercise, but there arefew data on clinically relevant outcomes. One small RCT including patients with mildCOPD compared the effect of high and low intensity exercise (at 80 % and 40 % of themaximum exercise capacity, respectively) exercise intensities and found larger physio-logical training effects from high intensity exercise.
DEVELOPMENT OF A MSW GASIFICATION MODEL FOR FLEXIBLE INTEGRATION INTO A MFA-LCA FRAMEWORK

This paper presents the development of a comprehensive gasification module designed to be integrated in a MFA-LCA framework. From existing gasification models present in the literature, the most appropriate modelling strategy is selected and implemented into the module. This module needs to be able to capture the influence of input parameters, such as gasification reactor type, oxidizing agent, feedstock composition and operating conditions on the process outputs, including syngas yield, its composition and LHV, as well as tar and char contents. A typical gasification process is usually modelled in four steps: drying, pyrolysis, oxidation and reduction. Models representing each of these steps are presented in this paper. Since the type of gasification reactor is taken into account in the module, models for downdraft moving bed and bubbling fluidized bed reactor are also reviewed. The gasification module will be integrated into a MFA framework (VMR-Sys), which enables calculation of relevant gasifier feedstock parameters, such as moisture content, composition, properties and particle size distribution. Outputs from the module will also include elemental compositions obtained from VMR-Sys calculations. Finally, all outputs from the module will be used to build LCA-inventory data.
Predictors of Treatment Completion for Patients Receiving Residential Drug and Alcohol Treatment

ObjectivesThe purpose of this research project was to determine the predictors of treatment outcomes among low-income inner city patients receiving residential treatment at a mid south drug and alcohol treatment facility. MethodsThis research project was an archival study that reviewed the case records of patients who had entered residential drug and alcohol treatment at the Adult Detoxification Unit during a 1-year period. Variables which address different areas of the patient's functioning were categorized into demographic, legal, employment/financial, and substance use predictor groups. ResultsAnalyses varied when opiate-dependent patients were included or removed from the analyses. It was revealed that recent adaptive functioning proved to be a pervasive predictor. ConclusionsWhen opiate-dependent patients are part of the patient population investigated, we recommend the combination of both parametric and nonparametric analyses to supplement the weaknesses of either analytical approach. When these atypical patients are not a part of the treatment program being studied, alcohol- and cocaine-dependent patients reveal nearly identical attrition rates.
Responsible Genetic Factors for Vasculitis in Kawasaki Disease

Kawasaki disease (KD) is an acute febrile illness of early childhood that is characterized by high fever, bilateral conjunctivitis, redness of the oral mucosa, polymorphous skin rash, indurative edema of the hands and feet, and cervical lymphadenopathy (Kawasaki, 1967). The major pathological lesion of KD is vasculitis of small and medium-sized arteries (Amano et al., 1979). The coronary arteries are the most severely affected and coronary artery lesions (CALs) occur in 15–25% of untreated patients (Kato et al., 1975), making KD a leading cause of childhood acquired heart disease in developed countries. The fact that the peak incidence of KD is at 9–11 months of age, which coincides with the waning of maternal immunity, indicates that infections could contribute to the pathogenesis of KD. However, despite more than 40 years of intensive research, the causative microorganism of KD remains unknown. On the other hand, epidemiological studies have revealed a significant role of genetic components in host susceptibility to KD pathogenesis.
Feasibility of Identifying Risk for Conductive Hearing Loss in a Newborn Universal Hearing Screening Program

Recurrent fluctuating conductive hearing losses in infancy are associated with an interference in several aspects of communication development. Unidenti fied early conductive hearing losses often have serious negative effects on the child. Although concern has grown about early-onset conductive hearing loss related to middle ear effusion, identifying such losses in infants before 6 months of age has not been feasible until recently. Virtually all existing neonatal hearing-screening programs are designed to iden tify infants with "significant" sensorineural or structural conductive hearing losses. For example, the risk factors described by the Joint Committee on Infant Hearing 1 were designed primarily to identify infants with sensorineural losses or conductive hearing losses associated with craniofacial, head, or neck abnormalities. Auditory brainstem re sponse (ABR) tests can be used with infants to differentiate between sensorineural and conductive hearing losses. To do so, mea surement of low frequency status (through tone pips or notched noise), the latency of wave I, and the establishment of intensity-latency functions must be included. 2 Due to the required time and level of profes sional skill involved, such procedures are almost never included in existing newborn hearing-screening programs. This article explores the potential of using transient evoked otoacoustic emis sions (TEOAE) in a neonatal screening program as a means of identifying persis tent fluctuating conductive losses occur ring before 6 months of age. A summary of the effects of early conductive hearing loss is presented first, followed by a review of the information on the incidence of otitis media and its risk factors. A review of avail able newborn screening techniques (in cluding ABR) and their potential for de tecting middle ear effusion leads to a discussion, based on the Rhode
ANÁLISE DOS PERSONAGENS BRASILEIROS DA FRANQUIA STREET FIGHTER - IDENTIDADE E REPRESENTAÇÃO NOS VIDEOGAMES.

No contexto da pós-modernidade, a identidade individual é ativamente construída a partir de relações de afeto e consumo, como por exemplo, o consumo de mídia. Os jogos digitais possibilitam que jogadores expressem-se e sintam-se representados através de seus protagonistas controláveis. Através de uma análise semiótica peirceana de três personagens, o presente trabalho propõe-se a investigar a evolução da representação do Brasil e do brasileiro na franquia japonesa Street Fighter ao longo dos 30 anos da série. Elucida ao final como cada um destes qualifica e simboliza o povo brasileiro a partir de diferentes características nacionais incutidas no imaginário estrangeiro.
CLINICAL AND DIAGNOSTICAL ASPECTSIN DAIRY MEDITERRANEAN BUFFALO MASTITIS

The goal of the present study was the verify the qualitative and quantitative numerical linear correlation between the most common diagnostics test (electrical conductivity, California Mastitis Test, somatic cells count and bacteriological milk culture) employed for detection of mastitis in Mediterranean Buffalo (Bubalus Bubalis). Four hundred and eighteen primiparous Mediterranean Buffaloes, randomly chosen between December 2011 and September 2012, were enrolled in the study. All the subjects with traumatic evidences of mastitis were discarded. A composite milk sample (pool of the 4 quarts) was collected from each animal, between days 30 and 150 after calving, during evening milking and send to laboratory for somatic cell count and bacteriological milk culture. Electrical conductivity and California Mastitis Test were recorded and performed, respectively, in farm after milking. Low correlation values between the most of variables were found, but a moderate strong coefficient between California Mastitis Test and somatic cells count was detected (0,657). The lowest correlation’s values were recorded between electrical conductivity and the other test because it showed a low ability to rightly identify buffalo udder health status. The diagnostic characteristic of electrical conductivity and California Mastitis Test measurements cannot adequately reflect Mediterranean Buffalo’s udder bacteriological status. A few informations, depending by selected threshold, can be reached by somatic cells count (sensibility and specificity of 41% and 88%, respectively, with cutoff of 100’000 cells/ml; 25,6% and 100% with that one of 200’000 cells/ml). At present, between the investigated diagnostic test, no association can be considered an efficient alternative to the gold standard for mastitis diagnosis, created for dairy cow and also used in Mediterranean Buffalo, represented by combined used of somatic cells count and bacteriological milk culture.
Efectos del contraste, excentricidad y posición en la detección de estímulos visuales en humanos

Introduccion. Los estudios en humanos sobre percepcion visual espacial tienen en comun proyectar estimulos en la retina central, pero difieren notablemente en cuanto a su contraste, excentricidad y posicion en el campo visual. Objetivo. Estudiar los efectos del contraste, excentricidad y posicion en la deteccion de estimulos visuales presentados en la retina central humana. Sujetos y metodos. Se estudiaron los tiempos de respuesta, en personas con vision normal, a la presentacion de estimulos (circulos grises de 0,5o de diametro) presentados al azar en ocho coordenadas polares, con tres excentricidades (2,15, 3,83 y 5,53o) y tres niveles de contraste (6, 16 y 78%). Resultados. Los estimulos presentados a 5,53o de excentricidad y contraste del 6% mostraron los tiempos de respuesta mas elevados. Con este contraste, los tiempos de respuesta fueron mayores en todas las excentricidades estudiadas. Por el contrario, con contrastes del 16 y 78%, los tiempos de respuesta fueron similares en las tres excentricidades. Para las ocho coordenadas polares, los tiempos de respuesta fueron homogeneos en la excentricidad de 3,83o y mostraron mayor variabilidad en las excentricidades de 2,15 y 5,53o. Conclusiones. De los tres factores analizados, el contraste es determinante en la deteccion de estimulos, especialmente en la excentricidad mayor. La posicion tambien influye cuando los estimulos se presentan con excentricidades pequenas o grandes, lo que sugiere que la distancia de los estimulos respecto al punto de fijacion es critica en la deteccion visual en este tipo de estudios.
Mechanisms of Contraction and Relaxation in Human Term Pregnant Myometrium

Mechanisms of Contraction and Relaxation in Human Term Pregnant Myometrium The study discusses the problem of role of various substances in the mechanisms of contraction and relaxation of human term pregnant myometrium in the experimental in vitro conditions. Human myometrium tissue samples were collected from term pregnant women who had to undergo Caesarean section. The effects of potassium ion channels openers and closers, phosphodiesterase inhibitors and tachykinins were measured in the reactivity of human term pregnant myometrium in the experimental in vitro conditions. Specific agonist-opener of KATP potassium ion channels - pinacidil significantly reduced contractile activity of human term pregnant myometrial strips induced by administration of oxytocin in in vitro conditions, while the effect of specific agonist-opener of BKCa2+ potassium ion channels - NS1619 was not significant. Glibenclamide, specific KATP potassium ion channels antagonist-closer significantly increased contractile activity of human term pregnant myometrial strips in in vitro conditions. The contractile effect of specific antagonist-closer of BKCa2+ potassium ion channels - tetraethylammonium was not significant. Phosphodiesterase-4 inhibitor - rolipram and phosphodiesterase-5 inhibitor - sildenaphil led to statistically significant decrease of oxytocin-induced contractile activity in human term pregnant myometrial strips in in vitro conditions. Tachykinins - neurokinin A, neurokinin B and substance P markedly stimulated the activity of the human term pregnant myometrial strips in in vitro conditions. The results showed the different effectiveness of potassium ion channels openers and closers, phosphodiesterase inhibitors as well as tachykinins in the mechanisms of contraction and relaxation of human term pregnant myometrium in in vitro conditions.