Miracle-dz/UniFAR-FTUs huggingface dataset:
ROLE OF STEROIDS IN REFRACTORY HYPOGLYCEMIA DUE TO AN OVERDOSE OF 10,000 UNITS OF INSULIN GLARGINE: A CASE REPORT AND LITERATURE REVIEW

ABSTRACT Objective: A massive overdose of insulin glargine is an emergent condition that causes prolonged and refractory hypoglycemia, which may lead to coma and even death. We present a case of an intentional overdose with the highest reported dose of 10,000 units of insulin glargine (Lantus®, 100 units/mL). In addition to the use of glucagon and octreotide, we report here the benefit of adding steroids to the regimen. Methods: The case report is accompanied by a review of the literature. Results: A 36-year-old female presented nearly 44 hours after a massive overdose of 10,000 units of insulin glargine. The patient was admitted to the intensive care unit and required continuous dextrose infusion for 150 hours along with frequent dextrose 50% boluses. Pharmacological therapies used included glucagon to promote glycogenolysis and gluconeogenesis, octreotide to prevent any endogenous insulin secretion from the pancreas, and steroids for their hyperglycemic effects. Although not much effect was noted on blo.
A spatial error-based cellular automata approach to reproducing and projecting dynamic urban expansion

Abstract Urban systems are featured by spatial autocorrelation, which may produce clustering of model residuals when simulating urban expansion using cellular automata (CA). Accurate identification of spatial autocorrelation and reduction of residual clustering are essential to accurate CA modeling of urban expansion. We developed a new CA approach (CASEM) using a spatial error model (SEM) that incorporates spatial autocorrelation. Using Zhengzhou City as a case study, we calibrated three types of CA models [e.g., logistic regression (Logit), spatial lag model (SLM) and SEM] from 2000 to 2010. Here, two important issues are the choice of the appropriate method (SLM vs. SEM) for urban expansion modeling and the applicability of CASEM for projecting urban scenarios. We validated the CASEM model from 2010 to 2017 and projected urban scenarios out to the year 2030 using this model. End-state assessment reveals that CASEM yields a higher overall accuracy (91.4%) in the calibration, but lower overall accuracy (83.8%) in the validation. For change assessment, CASEM yields a lower figure-of-merit (FOM; 31.8%) in the calibration but a higher FOM (35.2%) in the validation. We conclude that CASEM can accurately simulate urban expansion at Zhengzhou considering the fit performance of urban land transition rules, and the accuracy assessment of urban patterns and expansion. Scenario prediction using CASEM is therefore valuable for formulating useful urban planning regulations and in supporting sustainable urban development.
Asociación de infección por Chlamydia trachomatis con el diagnóstico de cervicitis aguda

Introduction: C hlamydia trachomatis infection is the most frequent sexually transmitted disease in the world causing heightened morbidity in women. Currently there are few studies about its prevalence in our population; therefore, the implementation of a pilot study about its frequency in women with and without acute cervicitis is necessary. Objective: Determine the association between Chlamydia trachomatis infection and the diagnosis of acute cervicitis in the consulting women in both the outpatient and inpatient services of the Hospital Universitario de Santander (HUS). Method: Case control study including 284 patients of adult age, non-pregnant and without menses who consulted HUS. Cases with acute cervicitis diagnosis and routine control ones were considered for the purpose of this study. Endocervical samples and a quick diagnostic method for Chlamydia trachomatis , Bioline Chlamydia SD were applied. Results: Mean age was 32.08 and 28.82 years for cases and controls, mean difference was 3.27, p = 0.001. There were also differences in the evaluation of marital status; 82.40% controls have a marital relationship versus 71.83% cases, p = 0.014; occupation, more students in the cervicitis group, p = 0.020; and alcohol consumption, 21.13% in cervicitis patients versus 11.27% in the control group, p = 0.024. Chlamydia prevalence was 7.04% in controls and 11.97% in cases, p = 0.157. There was no association between acute cervicitis and Chlamydia infection, OR = 1.79 (IC 95% 0.74 – 4.55). This lack of association persists after adjusting for confusing factors (OR = 1.71, IC 95% 0.72 – 4.04). In the multivariate analysis only alcohol consumption is associated with acute cervicitis, OR = 4.442 (IC 95% 1.362 – 14.215). Conclusions: There was no association between Chlamydia trachomatis infection and acute cervicitis. Prevalence was similar for both groups; there were no socio-demographic differences. Only alcohol consumption was associated with bacterial colonization and acute cervicitis . [Jaimes-Bravo JM. Association of Chlamydia trachomatis with the Diagnosis of Acute Cervicitis . MedUNAB 2015; 18(2): 116-124 ]
Experimental Investigation of the use of Nano-Lubricants Prepared in Different Al2O3 Nanoparticle Concentrations in a Cooling System

In this experimental study, the results of using a nano-lubricant instead of compressor oil in a cooling system were examined. In the cooling system used in the study, together with the R134a refrigerant, POE (polyol ester) oil was used as a base fluid, and a nano-lubricant prepared from AL2O3 nanoparticles was utilized. The experiments were carried out separately with nano-lubricants created by mixing AL2O3 nanoparticles in the ratios of 0.5% and 1% into POE oil. Additionally, 0.5% Triton X100 (TX-100) surfactant was used in the nano-lubricant in order to provide a homogeneous distribution in the nanofiber. As a result of the experiments, the highest COP value for the cooling system was obtained at the concentrations of 0.5% AL2O3 and 0.5% TX-100. In the experiments with pure POE oil, the COP value was increased by 18.27%. The power value drawn by the compressor was reduced by 12.53% at the concentrations of 0.5% AL2O3 and 0.5% TX-100.
Multidrug Resistant Carbapenemase-Producing Escherichia coli from Chicken Meat Reveals Diversity and Co-Existence of Carbapenemase Encoding Genes

Received: Revised: Accepted: Published online: October 02, 2018 February 03, 2019 February 08, 2019 April 06, 2019 Literature regarding multidrug resistant (MDR) carbapenemase-producing Escherichia coli (CPE) recovered from food-producing animals is lacking from Pakistan. Here, we report on the isolation and characterization of MDR-CPE recovered from retail-poultry meat in Khyber Pakhtunkhwa Pakistan. A total of 101 retail poultry-meat samples were screened for Escherichia coli and tested against 17 different antibiotics through disc diffusion test to define MDRs. MDR isolates were genotyped by PCR for carbapenemase-encoding elements. Finally, integron typing, insertion sequence common region 1 (ISCR1) and its association with carbapenemaseencoding genes was established through PCR. Of the 33 E. coli isolates, 28 (Phylogroup B2=39.2% (11/28), A=32.1 % (9/28) and group D=28.5% (8/28) were MDR displaying resistance to cefotaxime, tetracycline, ampicillin and trimethoprimsulfamethoxazole, while, 96.4, 92.8, 89.2 and 85.7% were also found resistant to colistin-sulphate, enrofloxacin, doxycycline and ciprofloxacin, respectively. The blaVIM was predominantly identified in 8 (28.5%) isolates followed by blaNDM 4/28 (14.2%) and 2 isolates were carrying a combination of blaVIM+blaNDM. Class-1 integron was detected in 21 (75%), class-2 and class-3 integrons were detected in 25% and 7.1%, respectively. ISCR1 element was identified among 11 isolates (39.28%) that was found associated with blaVIM gene among 3 isolates (27.25%) suggesting involvement in its mobilization. We report the incidence of E. coli carrying carbapenemase-encoding genes located on the plasmids carrying integron 1 recovered from retail-poultry-meat in Mardan, Pakistan. ©2019 PVJ. All rights reserved
Analysis of Childhood Social Development to Single Parents

The purpose of this study is to find out whether there is a significant relationship between: (1) achievement of social development in childhood who have single parents, (2) how is the social behavior of children who have single parents, (3) how childrens social behavior who is cared for by a single mother, (4) how is the social behavior of a child cared for by a single father. This study was an analytic observational study with a cross sectional design. The population of this study was all early childhood education in 3 kindergarten schools in Medan City. The research method used in this study is a qualitative analytical descriptive method. The sampling technique used is Area sampling. Data collection techniques for social development using questionnaires, interviews, documentation and observation. The data analysis technique uses 3 techniques, namely data reduction, data presentation and conclusion drawing. Based on the results of the data analysis and the discussion carried out obtained: (1) There is a difference between the social development of children with single parents and complete parents where children with single parents tend to have unstable emotions. They are easier to cry when disturbed by their friends for those who are cared for by a single mother, for those who are cared for by a single father, they tend to be angry, rebellious and hit when they are disturbed by their friends; (2) engagement parenting conducted in independent and not involved to the other; (3) accessibility is a single parent, father always give time to accompany for playing and activities his child everyday.
THE EFFECT OF L- ARGININE ON OXIDATIVE STRESS AND MICROALBUMINURIA IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CHRONIC KIDNEY DISEASE

Background. One of the severest complications of diabetes is diabetic kidney disease (DKD). Microalbuminuria (MAU) is one of the first signals of DKD and an important pathogenetic mechanism of disease progression. With diabetes dramatically antioxidant properties worsen. Objective. The aim was to investigate the effect of L-arginine on oxidative stress parameters and microalbuminuria in type 2 diabetes mellitus and chronic kidney disease patients. Methods. Total of 57 patients with type 2 diabetes mellitus and chronic kidney disease and 30 healthy subjects (control group) were included in the study. The patients were divided into 2 congruent groups. The 1-st group of patients (n=33), in addition to standard therapy, received L-arginine 4.2 g intravenously for 5 days, after that they took it 1,0 g orally three times a day during meals for 1 month. The second group of patients (n=24) received a standard therapy. The concentration of lipid peroxidation products was measured by a spectrophotometric method. The determination of MAU was carried out in morning portion of urine immunological semiquantitative using test strips. Results. Significant improvement in indexes of lipid peroxidation was observed in both groups after therapy (p˂0.01), but in patients treated with L-arginine it was more expressed (p˂0,01). The standard therapy did not significantly affect the level of MAU (p˃0,05). The patients treated with L-Arginine, showed a significant reduction in MAU (p˂0.01). Conclusions. The usage of L-arginine facilitates the correction of lipid peroxidation processes and reduces the severity of microalbuminuria in patients with diabetic kidney disease that slowing its progression.
Behavioral evidence for memory replay of video episodes in macaque monkeys

Humans recall the past by replaying fragments of events temporally. Here, we demonstrate a similar effect in macaques. We trained six rhesus monkeys with a temporal-order judgement (TOJ) task and collected 5000 TOJ trials. In each trial, they watched a naturalistic video of about 10 s comprising two across-context clips, and after a 2-s delay, performed TOJ between two frames from the video. The monkeys apply a non-linear forward, time-compressed replay mechanism during the temporal-order judgement. In contrast with humans, such compression of replay is however not sophisticated enough to allow them to skip over irrelevant information by compressing the encoded video globally. We also reveal that the monkeys detect event contextual boundaries and such detection facilitates recall by an increased rate of information accumulation. Demonstration of a time-compressed, forward replay like pattern in the macaque monkeys provides insights into the evolution of episodic memory in our lineage. Impact Statement Macaque monkeys temporally compress past experiences and use a forward-replay mechanism during judgment of temporal-order between episodes.
Bel/Boy Oranı ve Diğer Antropometrik Ölçümlerin Kronik Hastalık Riski ile İlişkisinin Değerlendirilmesi

Objective: The aim of this work was to determine the relationship between the anthropometric measurements used in the definition of obesity and biochemical markers which is related to risk of chronic diseases such as type 2 DM and cardiovascular disease. Materials and Methods: This study was carried out on 180 participants aged 18-85 years (146 women, 34 men) and applied between 02 January 2014 and 31 December 2014 at Başkent Ankara Hospital Ümitköy Diet Polyclinic. The participants biochemical and anthropometric data were evaluated. Results: The mean BMI of study group was 28.8±5.25 kg/m and waist to height ratio of study group was 0.53±0.10. 39.7% of the women and 50% of the men were in the risk group for waist circumference values. The frequency of waist to hip ratio in the risk group was 85.3% in women, whereas this frequency was 67.6% in men. There was a positive and significant correlation between BMI, waist circumference, waist to height ratio, waist to hip ratio and fasting blood glucose, HbA1c, LDL cholesterol and TG (p<0.05). There was a negative significant correlation between BMI, waist circumference, waist to height ratio, waist to hip ratio and HDL cholesterol. There was a positive and significant correlation between BMI, waist circumference, waist to height ratio, waist to hip ratio, body fat percentage and diagnosis of insulin resistance (p<0.05). There was a positive and significant correlation waist to hip ratio and diagnosis of DM, hypertension (p<0.05). Conclusion: There was no superiority between the anthropometric measurements used in this study. Waist to height ratio and other anthropometric measurements were considered risk factors for chronic diseases such as type 2 DM and cardiovascular diseases.
Association of Candidate Single Nucleotide Polymorphisms Related to Candidate Genes in Patients With Schizophrenia

Introduction: Schizophrenia is a chronic heterogenic neurodevelopment disorder. Many genes interfere in the development of SCZ. All four genes, NrCAM, PRODH, ANK3, and ANKK1, which were evaluated in this study, were previously reported to be associated with Schizophrenia. The NrCAM contributes to creating cognitive deficiencies through the CAM’s signaling pathway. PRODH plays a vital role in creating SCZ negative symptoms through the signaling pathway of glutamatergic and NMDA receptors. ANK3 affects ion channel and molecular adhesion in Ranvier and initial segments of axons, leading to mental retardation, sleep disorder, and SCZ. ANKK1 encodes a protein kinase and was reported to be associated with alcohol addiction, Attention Deficit Hyperactivity Disorder (ADHD), and SCZ. Methods: The subjects were selected from Schizophrenic patients referring to the Psychiatric Ward of Imam-Hussein Hospital and Schizophrenic Patients Support Institution (AHEBBA). 95 (30 Schizoaffective patients, 57 Paranoid patients, and 8 disorganized) patients were recruited as the subjects in the present case-control association study. 120 healthy subjects were recruited from the Tehran Medical Genetics Laboratory staff and a group of students from the Islamic Azad University of Science and Research in Tehran. The genotypes were determined with molecular genotyping techniques of PCR-RFLP, ARMS-PCR, and Cycle sequencing. Results were analyzed by the Chi-Square test using SPSS V. 24 and R, SNP STATE Package to investigate significant differences between cases and controls. Results: The incidence of schizophrenia was 68% and 32% among men and women, respectively. The evaluation of the allelic association between schizophrenia and all the candidate SNPs showed a significant association between NrCAM’s SNP rs10235968 and SCZ (P=0.001). Haplotype T, T, C in rs10235968, rs6967368, rs3763463, respectively, within the NrCAM gene, showed significant association with schizophrenia disorder (P=0.0001). Conclusion: No association was found between other candidate SNPs and SCZ among the subjects.
Investments to accelerate reductions in maternal mortality. Findings from expenditure studies in Uganda and Zambia for the Saving Mothers Giving Life Partnership.

To document actual financial resources invested as part of the SMGL partnership USAID asked the Health Policy Initiative (HPI) Costing Task Order in Zambia and the Health Policy Project (HPP) in Uganda to undertake expenditure analyses of the pilot phase. The two studies were to answer: "What additional expenditures were made to reduce maternal mortality in SMGL districts during the pilot phase? " The data from the expenditure analyses would be used to better understand the magnitude and composition of the actual expenditures invested to strengthen service delivery during the pilot period and to inform budget estimation for future expansion of the SMGL model within Zambia and Uganda and into new countries. The first phase of SMGL was implemented in four districts of each country: in Zambia Mansa in Luapula Province Lundazi and Nyimba in Eastern Province and Kalomo in Southern Province; in Uganda Kabarole Kamwenge Kibaale and Kyenjojo all of which are contiguous and located in the Western Region. The timeframe for the expenditure analyses totaled 20 months in Zambia (October 1 2011-May 31 2013) and 17 months in Uganda (January 1 2012-May 31 2013). During this time significant investments were made in both countries to enable districts to provide safe obstetric and neonatal care.
Elbow injuries in the pediatric athlete

Chronic repetitive stress to the developing osteoligamentous structures of the elbow places the pediatric athlete at risk for a number of sports-related elbow injuries. The specific type of injury encountered is dependent on the sport as well as the developmental stage of the physes and apophyses. The most common pathologies encountered are medial sided injuries due to valgus overload, olecranon apophysitis and stress fractures, and osteochondral injuries of the capitellum. As youth sports participation continues to increase, so too does the incidence of pediatric elbow injuries. This review will focus on the diagnosis, treatment, and prevention of common elbow pathologies in young athletes.
Empatia com equipes multidisciplinares na fase de Ideação do processo de design Thinking

This paper focuses on empathy in the Ideation phase of the Design Thinking process. The bibliographical review on empathy, Design Thinking and multidisciplinary teams is the basis of experiments developed to meet the demands of a social business. Results corroborate the perception that empathy can be achieved through collaborative multidisciplinary teams to build a scope. Finally, the theoretical gap is described and the opportunities for future research are presented.
Developing Teacher Candidates' Formative Assessment Practices

This chapter describes an initiative to better prepare teacher candidates to use formative assessment practices in their elementary mathematics instruction. Specifically, the initiative involved a curriculum and pedagogical redesign of an elementary mathematics methods course sequence. During the redesign implementation, the instructors intentionally modeled formative assessment practices for teacher candidates and had teacher candidates complete scaffolded field-based assignments in their elementary field placement classrooms in order to practice formative assessment strategies. Throughout the chapter, there are illustrative examples of how the instructors implemented this initiative as well as how teacher candidates carried out the formative assessment practices in their settings. The chapter concludes with a discussion about teacher candidate growth and challenges when learning about and implementing formative assessment practices in mathematics. Developing Teacher Candidates’ Formative Assessment Practices: Linking Mathematics Teaching to Assessing Student Thinking
Prescribing practices for pediatric out-patients: A case study of two teaching hospitals in Nigeria

Purpose : The objective of this study was to evaluate drug utilization pattern in the pediatric departments of two tertiary health facilities in Nigeria using WHO core prescribing indicators. Methods : Using a cross-sectional retrospective study approach, prescriptions randomly selected for a period of 6 months from the pediatric out-patient departments of two tertiary hospitals: Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka and Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi in South- Eastern Nigeria were assessed. Prescribing indicators as listed by WHO were calculated and analyzed using SPSS version 20. Results : A total of 750 prescriptions (450 from NAUTH and 300 from COOUTH) containing 2,739 drugs were assessed. The mean number of drugs prescribed per encounter (mean ± SD) at NAUTH was 3.5 ± 0.9 and 3.8 ± 1.1 in COOUTH. The percentage of antibiotics prescribed per encounter in COOUTH and NAUTH were 72.3 and 77.1 %, respectively, whereas drugs prescribed by generic names were 61.7 and 64.2 %, respectively. Injections prescribed per encounter were above acceptable range, and percentages of drugs prescribed from essential medicine lists in the two hospitals were > 85 %. Conclusion: This study identified irrational use of antibiotics, polypharmacy, non-adherence to generic prescribing and high use of injections in both hospitals. The need for improvement in prescription patterns is underscored. Keywords : Prescription pattern, Pediatric outpatients, WHO indicators, Irrational use, Antibiotics, Polypharmacy
Postmortem Biochemistry and Toxicology

The aim of postmortem biochemistry and toxicology is either to help establish the cause of death, or to gain information on events immediately before death. If self-poisoning is suspected, the diagnosis may be straightforward and all that could be required is confirmation of the agents involved. However, if the cause of death is not immediately obvious then suspicion of possible poisoning or of conditions such as alcoholic ketoacidosis is of course crucial. On the other hand, it may be important to investigate adherence to prescribed therapy, for example with anticonvulsants or antipsychotics, hence sensitive methods are required. Blood sampling (needle aspiration, peripheral vein, for example femoral, ideally after proximal ligation) before opening the body minimizes the risk of sample contamination with, for example, gut contents or urine. Other specimens (stomach contents, urine, liver, vitreous humor) may also be valuable and may be needed to corroborate unexpected or unusual findings in the absence of other evidence. The site of sampling should always be recorded. The availability of antemortem specimens should not necessarily preclude postmortem sampling. Appropriate sample preservation, transport, and storage are mandatory. Interpretation of analytical toxicology results must take into account what is known of the pharmacokinetics and toxicology of the agent(s) in question, the circumstances under which death occurred including the mechanism of exposure, and other factors such as the stability of the analyte(s) and the analytical methods used. It is important to realise that changes may occur in the composition of body fluids, even peripheral blood, after death. Such changes are likely to be greater after attempted resuscitation, and with centrally-acting drugs with large volumes of distribution given chronically, and may perhaps be minimised by prompt refrigeration of the body and performing the autopsy quickly.