Miracle-dz/UniFAR-FTUs huggingface dataset:
CPAP vs Mandibular Advancement Devices and Blood Pressure in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis.

IMPORTANCE Obstructive sleep apnea is associated with higher levels of blood pressure (BP), which can lead to increased cardiovascular risk. OBJECTIVE To compare the association of continuous positive airway pressure (CPAP), mandibular advancement devices (MADs), and inactive control groups (placebo or no treatment) with changes in systolic BP (SBP) and diastolic BP (DBP) in patients with obstructive sleep apnea. DATA SOURCES The databases of MEDLINE, EMBASE, and the Cochrane Library were searched up to the end of August 2015 and study bibliographies were reviewed. STUDY SELECTION Randomized clinical trials comparing the effect of CPAP or MADs (vs each other or an inactive control) on BP in patients with obstructive sleep apnea were selected by consensus. Of 872 studies initially identified, 51 were selected for analysis. DATA EXTRACTION AND SYNTHESIS Data were extracted by one reviewer and checked by another reviewer. A network meta-analysis using multivariate random-effects meta-regression was used to estimate pooled differences between each intervention. Meta-regression was used to assess the association between trial characteristics and the reported effects of CPAP vs inactive control. MAIN OUTCOMES AND MEASURES Absolute change in SBP and DBP from baseline to follow-up. RESULTS Of the 51 studies included in the analysis (4888 patients), 44 compared CPAP with an inactive control, 3 compared MADs with an inactive control, 1 compared CPAP with an MAD, and 3 compared CPAP, MADs, and an inactive control. Compared with an inactive control, CPAP was associated with a reduction in SBP of 2.5 mm Hg (95% CI, 1.5 to 3.5 mm Hg; P < .001) and in DBP of 2.0 mm Hg (95% CI, 1.3 to 2.7 mm Hg; P < .001). A 1-hour-per-night increase in mean CPAP use was associated with an additional reduction in SBP of 1.5 mm Hg (95% CI, 0.8 to 2.3 mm Hg; P < .001) and an additional reduction in DBP of 0.9 mm Hg (95% CI, 0.3 to 1.4 mm Hg; P = .001). Compared with an inactive control, MADs were associated with a reduction in SBP of 2.1 mm Hg (95% CI, 0.8 to 3.4 mm Hg; P = .002) and in DBP of 1.9 mm Hg (95% CI, 0.5 to 3.2 mm Hg; P = .008). There was no significant difference between CPAP and MADs in their association with change in SBP (-0.5 mm Hg [95% CI, -2.0 to 1.0 mm Hg]; P = .55) or in DBP (-0.2 mm Hg [95% CI, -1.6 to 1.3 mm Hg]; P = .82). CONCLUSIONS AND RELEVANCE Among patients with obstructive sleep apnea, both CPAP and MADs were associated with reductions in BP. Network meta-analysis did not identify a statistically significant difference between the BP outcomes associated with these therapies.
Change in breastfeeding patterns in Scotland between 2004 and 2011 and the role of health policy.

BACKGROUND Substantial investments in promoting breastfeeding have taken place in the past 10 years in Scotland. This study assesses whether there were significant changes in breastfeeding initiation and mixed breastfeeding duration between 2004-2005 and 2010-2011. METHODS This study uses data from two nationally representative cohorts of babies in Scotland born between June 2004-May 2005 (N = 5030) and March 2010-February 2011 (N = 5838). Multivariate logistic regression for breastfeeding initiation and multivariate survival analysis for breastfeeding duration using cross-sectional data based on maternal recall were performed. RESULTS An increase in breastfeeding initiation from 60 to 63% was not significant (P = 0.125), and controlling for covariates, there was no significant cohort effect when comparing breastfeeding initiation between cohorts [odds ratio (OR) 1.02, 95% confidence interval (CI) 0.91-1.13]. For breastfeeding duration of up to 1 month, the 2010-11 cohort was more likely to give up breastfeeding sooner (HR 1.23, 95%CI 1.12-1.34). However, for breastfeeding durations of >1-6 months, or ≥6 months, the 2010-11 cohort was significantly less likely to give up breastfeeding sooner (HR 0.79, 95%CI 0.70-0.88 and HR 0.79, 95%CI 0.68-0.92, respectively). Breastfeeding duration increased the most among mothers with fewer educational qualifications, and mothers with no qualifications in 2010-11 were far less likely to stop breastfeeding early compared with their counterparts in 2004-05 (HR 0.32, 95%CI 0.17-0.58). CONCLUSION After the 1 month mark, babies born in 2010-11 were more likely to be breastfed for longer compared with those born in 2004-05, and this effect was particularly pronounced among more disadvantaged families. The potential causal role of health policy is discussed.
Prenatal exposure to dexamethasone in the mouse induces sex‐specific differences in placental gene expression

Prenatal stress during pregnancy leads to sex‐specific effects on fetal development and disease susceptibility over the life span; however, the origin of sex differences has not been identified. The placenta not only plays a key role in fetal growth and development throughout pregnancy, but also affects the fetal programming underlying subsequent adult health and accounts. Therefore, sex‐specific adaptation of the placenta may be central to the sex differences in fetal growth and survival. Here, we analyzed the effects of prenatal dexamethasone (Dex) on sex‐specific changes in placental gene expression using RNA‐Seq. Placental tissues from males and females were separated into two developmentally distinct fetal and maternal parts at E11.5 stage. The majority of genes in female placentas were downregulated by prenatal Dex, whereas those were mostly maintained or rather upregulated in male placentas. RNA‐Seq results were validated using independent biological replicates from the same stage and placental tissue samples from E18.5 by realtime PCR assays. Activation of various inflammatory response‐related genes, chemokines and their receptors, particularly in male placentas, strongly implies that prenatal Dex exposure causes sex‐specific physiological responses that can lead to inflammatory diseases involving vascular pathology.
Resistencia antimicrobiana en oftalmología

La resistencia antimicrobiana es un problema en ascenso en la oftalmología. Los microorganismos resistentes incrementan el riesgo de complicaciones y elevan el costo del tratamiento. El conocimiento de la epidemiología y de los mecanismos de resistencia puede guiar el uso apropiado de antibióticos en el manejo y prevención de conjuntivitis, queratitis, endoftalmitis y otras enfermedades infecciosas oculares. El objetivo del presente estudio es describir los principales mecanismos de resistencia antimicrobiana en oftalmología. Para su realización se llevó a cabo un estudio exploratorio donde se revisó la bibliografía nacional e internacional sobre el tema. Las bacterias adquieren la capacidad de resistir la acción de los antibióticos por medio ◗ Abstract
Clinical Effectiveness, Quality of Life and Costs of Treatment in Transfusion-Dependent Thalassemia Patients Undergoing Iron-Chelating Therapy; Deferiprone

A major complication of long-term blood transfusion in thalassemia patients is a serious iron overload. Excessive iron deposits in major organs and eventually results in organ damage. Deferiprone (DFP) is an effective oral iron chelator that promotes iron excretion and prevents the progression of iron accumulation assessed by serum ferritin levels. To evaluate the overall impact of DFP in transfusion-dependent thalassemia patients, this study aimed to determine the clinical effectiveness, health-related quality of life (HRQOL) and treatment costs of DFP. A cross-sectional study was conducted among 50 transfusion-dependent thalassemia patients who received DFP at Maharaj Nakorn Chiang Mai Hospital. The data of clinical effectiveness and costs of treatment were collected from the questionnaire and retrospectively reviewed over a 12-month period from medical records and hospital database. HRQOL was assessed by using the questionnaire, EQ-5D-3L (Thai version). The result showed the mean serum ferritin level (µg/L) at baseline and final level of 1367±935 and 1386±541, respectively. The mean EQ-5D-3L and VAS scores were 0.80±0.16 and 81.9±14.0, respectively. The adherence to treatment was found to be poor and the common adverse events reported were headache, back pain, arthralgia, fever, elevated liver enzyme, nausea/vomiting, abdominal pain and diarrhea. The total annual direct costs of treatment were estimated to be 54,000 Thai Baht (THB)/patient. In conclusion, DFP was effective in maintaining serum ferritin level in transfusion-dependent thalassemia patients with reasonable costs of treatment. Although patients’ HRQOL assessments were favorable, adherence to treatment was poor with more adverse events reported.
Cross-national time trends in bullying victimization in 33 countries among children aged 11, 13 and 15 from 2002 to 2010.

BACKGROUND Bullying among children and adolescents is a public health concern; victimization is associated with psychological and physical health problems. The purpose of this study is to examine temporal trends in bullying victimization among school-aged children in Europe and North America. METHODS Data were obtained from cross-sectional self-report surveys collected as part of the Health Behaviour in School-aged Children (HBSC) study from nationally representative samples of 11-, 13- and 15-year-olds, from 33 countries and regions which participated in the 2001-02, 2005-06 and 2009-10 surveys. Responses from 581 838 children were included in the analyses. Binary logistic regression was used for the data analyses. RESULTS The binary logistic regression models showed significant decreasing trends in occasional and chronic victimization between 2001-02 and 2009-10 across both genders in a third of participating countries. One country reported significant increasing trends for both occasional and chronic victimization. Gender differences in trends were evident across many countries. CONCLUSION Overall, while still common in many countries, bullying victimization is decreasing. The differences between countries highlight the need to further investigate measures undertaken in countries demonstrating a downward trend.
Private and public modes of bicycle commuting: a perspective on attitude and perception.

BACKGROUND Public bicycle-sharing initiatives can act as health enhancement strategies among urban populations. The aim of the study was to determine which attitudes and perceptions of behavioural control toward cycling and a bicycle-sharing system distinguish commuters with a different adherence to bicycle commuting. METHODS The recruitment process was conducted in 40 random points in Barcelona from 2011 to 2012. Subjects completed a telephone-based questionnaire including 27 attitude and perception statements. Based on their most common one-way commute trip and willingness to commute by bicycle, subjects were classified into Private Bicycle (PB), public bicycle or Bicing Bicycle (BB), Willing Non-bicycle (WN) and Non-willing Non-bicycle (NN) commuters. After reducing the survey statements through principal component analysis, a multinomial logistic regression model was obtained to evaluate associations between attitudinal and commuter sub-groups. RESULTS We included 814 adults in the analysis [51.6% female, mean (SD): age 36.6 (10.3) years]. BB commuters were 2.0 times [95% confidence interval (CI) = 1.1-3.7] less likely to perceive bicycle as a quick, flexible and enjoyable mode compared to PB. BB, WN and NN were 2.5 (95% CI = 1.46-4.24), 2.6 (95% CI = 1.53-4.41) and 2.3 times (95% CI = 1.30-4.10) more likely to perceive benefits of using public bicycles (bicycle maintenance and parking avoidance, low cost and no worries about theft and vandalism) than did PB. CONCLUSION Willing non-bicycle and public-bicycle commuters had more favourable perception toward public-shared bicycles compared to private cyclists. Hence, public bicycles may be the impetus for those willing to start bicycle commuting, thereby increasing physical activity levels.
Resección transuretral de próstata bipolar vs monopolar. Análisis peri y posoperatorio de los resultados

Analizar las posibles ventajas que ofrece la Reseccion Transuretral Prostatica Bipolar frente a la Reseccion Transuretral Prostatica Monopolar o convencional durante la intervencion quirurgica por hiperplasia prostatica, tanto en el periodo transoperatorio como en el posoperatorio inmediato. Metodo: Estudio descriptivo analitico en 15 pacientes que fueron intervenidos con resector bipolar Gyrus ACMI y 15 con resector monopolar. Resultados: La edad media fue de 67,4 anos en el grupo monopolar frente 68,1 anos en el grupo bipolar; el volumen ecografico prostatico fue de 58.8 cc vs 49.6 cc. El sangrado durante el corte se califico como moderadoabundante en 86% monopolar vs 46% bipolar (p < 0.05). La capacidad de coagulacion fue notable-excelente en el 100% del tratamiento monopolar vs 7% tratamiento bipolar (p < 0.05). El grado de adherencia de fragmentos al asa fue moderado-abundante en el 100% monopolar vs 20% bipolar (p < 0.05). No hubo diferencias significativas en el resto de las variables comparadas. Conclusiones: En nuestra experiencia, la reseccion transuretral de prostata bipolar presenta menor adherencia de fragmentos y una buena capacidad de coagulacion durante el corte, lo cual mejora la visibilidad para el cirujano durante el transoperatorio, ambos presentan resultados similares posoperatorios
Diffusion‐weighted imaging changes in cerebral watershed distribution following neonatal encephalopathy are not invariably associated with an adverse outcome

Patterns of injury in term‐born infants with neonatal encephalopathy following hypoxia–ischaemia are seen earlier and are more conspicuous on diffusion‐weighted magnetic resonance imaging (DW‐MRI) than on conventional imaging. Although the prognostic value of DW‐MRI in infants with basal ganglia and thalamic damage has been established, data in infants in whom there is extensive injury in a watershed distribution are limited. The aim of this study was to assess cognitive and functional motor outcome in a cohort of infants with changes in a predominantly watershed distribution injury on neonatal cerebral MRI, including DWI.
Induction of Abortion in the First Trimester by Misoprostol or Misoprostol With Letrozole

Background: Management of abortion is an important issue in gynecology. Several millions of spontaneous abortions occur yearly and more than a million induced abortions are performed in the USA. Objectives: The aim of this study was to compare the effect of misoprostol alone and misoprostol with letrozole in the induction of abortion in the first trimester of pregnancy in the Qazvin city of Iran. Patients and Methods: Seventy female candidates for legal abortion within the first trimester of pregnancy were divided to two groups: misoprostol alone and misoprostol with letrozole. The complete abortion, time to open the internal os of the cervix, time to complete the abortion, and drug-induced side effects of misoprostol and letrozole were recorded and analyzed. Results: The complete abortion rate was 69.7% in the misoprostol and letrozole group and 30.3% in the misoprostol group. Incomplete abortion was 32.4% in the misoprostol and letrozole group, and 67.6% in the misoprostol group (P = 0.004). Bleeding, cervix os opening time, and time to complete abortion from induction of drugs were similar in both groups (P > 0.05). There were no medical complications in both groups. Conclusions: Misoprostol plus letrozole was more effective for inducing abortion in the first trimester of pregnancy compared to misoprostol alone.
Evaluación de la concentración de mercurio en arroz (Oryza sativa) crudo y cocido procedente del municipio de San Marcos– Sucre y zona aurífera del municipio de Ayapel – Córdoba

Introduction: Metals are found in mostly all kind of food. Presence of toxic metals such as mercury are relevant for public health safety, due to the adverse effects it has on human health. Objective: To evaluate mercury concentrations in raw and cooked rice (Oryza sativa) from San Marcos municipality in Sucre and Ayapel gold zone in Cordoba. Methodology: The present study is exploratory and experimental. Sample collection was conducted in rice harvesting time (September) and three repetitions of each type or variety of rice were taken (Fedearroz 2000 - LD 473). Cooking of rice was made under laboratory standards similar to those used by residents of the communities where the samples were collected. For statistical analysis of the relationship between cooking treatment and the concentration of total mercury in samples, we carried out a simple correlation analysis. Determination of statistically significant differences, between samples of raw and cooked rice, was performed using a t-test and Anova. Results: Low concentrations of total mercury and methylmercury were presented in raw and cooked rice. Furthermore, it was found that food cooking processes decreases HgT concentrations. Conclusion: Inhabitants of the municipalities under study are exposed to minimal concentrations of mercury that could be harmful to their health due to high intake of this cereal in their communities' diet.
Hígado graso no alcohólico: una entidad cada vez más frecuente y de pronóstico incierto

La enfermedad de higado graso no alcoholica, en ingles non alcoholic fatty liver disease (NAFLD), es definida como una acumulacion excesiva de grasa en los hepatocitos. Presenta una prevalencia mundial de alrededor del 15 al 25%. Los factores de riesgo asociados frecuentemente a NAFLD son obesidad, diabetes tipo 2 y dislipemia. Por un lado se ha propuesto que una disfuncion mitocondrial jugaria un papel fundamental en el desarrollo de la enfermedad. Por otro lado, se enfoca en el sindrome de insulinoresistencia, unica alteracion metabolica asociada fuertemente con este cuadro. La enfermedad se sospecha en personas con caracteristicas de insulinoresistencia como el sindrome metabolico y en aquellos con niveles sericos de transaminasas elevadas. Existen diferentes ensayos no invasivos con marcadores bioquimicos para predecir el desarrollo de fibrosis o de esteatohepatitis. Las opciones terapeuticas en pacientes con NAFLD son limitadas y la perdida de peso permanece como la terapia mas recomendada.
What constitutes cerebral palsy in the twenty‐first century?

Determining inclusion/exclusion criteria for cerebral palsy (CP) surveillance is challenging. The aims of this paper were to (1) define inclusion/exclusion criteria that have been adopted uniformly by surveillance programmes and identify where consensus is still elusive, and (2) provide an updated list of the consensus concerning CP inclusion/exclusion when a syndrome/disorder is diagnosed.
Low vs high glycemic index diet.

account for the discrepancy? Among eligible patients at our medical center, both options are presented as clinically equivalent; despite this, in 2013 we observed that 41% opted for conventional WBI and 59% chose hypofractionation,5 thereby generating considerable excess cost. This suggests that patient preference may play a significant role in the observed international differences. It is encouraging that rates of hypofractionated WBI approximately tripled over the study period. In an era of patientdriven medical decision making, still wider adoption is likely to require either clear evidence of superiority or economic incentives that favor the less costly of the 2 medically equivalent therapies.
Separate visual systems for perception and action: a framework for understanding cortical visual impairment

The visual control of skilled goal‐directed movements requires transformations of incoming visual information that are quite different from those required for visual perception. These differences in the required computations have led to the emergence of dedicated visuomotor modules in the dorsal visual stream of the cerebral cortex that are quite separate from the networks in the ventral visual stream that mediate our conscious perception of the world. Although the identification and selection of goal objects and an appropriate course of action depends on the perceptual machinery of the ventral stream and associated cognitive modules in the temporal and frontal lobes, the execution of the subsequent goal‐directed action is mediated by dedicated online control systems in the dorsal stream and associated motor areas. This functional distinction can provide a useful framework for interpreting the range of perceptual and visuomotor deficits observed in children with cortical visual impairment.
The multiple faces of Dravet syndrome

head trauma under 18 months of age. Pediatr Neurol2013; 48: 220–6.3. Ivanov I, Zlatareva D, Pacheva I, Panova M. Does lentic-ulostriate vasculopathy predipose to ischemic braininfarct? A case report J Clin Ultrasound 2012; 40: 607–10.4. Hills NK, Johnston SC, Sidney S, Zielinski BA, FullertonHJ. Recent trauma and acute infection as risk factors forchildhood arterial ischemic stroke. Ann Neurol 2012; 72:850–8.5. Ishihara C, Sawada K, Tateno A. Bilateral basal gangliainfarction after mild head trauma. Pediatr Int 2009; 51:829–31.
γ-secretase inhibitors for treating Alzheimer’s disease: rationale and clinical data

There are no drugs available for slowing down the rate of deterioration of patients with Alzheimer’s disease (AD). With the aim of altering the natural history of the disease, the pharmaceutical industry has designed and developed several compounds inhibiting γ-secretase, the enzymatic complex generating β-amyloid (Aβ) peptides (Aβ1–40 and Aβ1–42), believed to be involved in the pathophysiological cascade of AD, from amyloid precursor protein (APP). This article briefly reviews the profile of γ-secretase inhibitors that have reached the clinic. Studies in both transgenic and nontransgenic animal models of AD have indicated that γ-secretase inhibitors, administered by the oral route, are able to lower brain Aβ concentrations. However, few data are available on the effects of these compounds on brain Aβ deposition after prolonged administration. γ-secretase inhibitors may cause abnormalities in the gastrointestinal tract, thymus, spleen, skin, and decrease in lymphocytes and alterations in hair color in ex.
Morbidity pattern of diabetic admissions at the Abia State University Teaching Hospital, Aba, Nigeria

Diabetes mellitus is associated with numerous complications depending on the degree of glycaemic control. The aim of this study is to determine the prevalence of common diabetic complications associated with the disease. A retrospective study of medical admissions of diabetic patients from January 2009 to December 2011 was conducted. The total number of medical admissions for the period under study was 5862 patients; 853 (14.5%) of whom were diabetic patients. Of the 853 diabetic patients, 326 (38.22%) were males and 527 (61.28%) were females. Their ages ranged from 22 to 85 (mean 56.4+12.7 years). The indications for admission were chronic diabetic complications of which uncontrolled diabetes, neuropathy and diabetic foot ulcers were the commonest. There was a low incidence of retinopathy (2.5%) and hypoglycaemia (1.8%). The high incidence of leg ulcer/gangrene in diabetics and the possibility of resultant amputation calls for strict glycaemic control with good health education in order to reduce the risk of development of complications. Key Words : Morbidity, Diabetic admissions, glycaemic control, Aba, Nigeria.
Oral Health of People with Psychiatric Disorders

the and deficient and/or and maxillofacial tissues using biocompatible materials. Periodontology, Periodontics, of oral healthcare supporting structures of teeth, diseases, and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. Oral biology deals with the microbiota and their interaction within the oral region. Research in oral health and systemic conditions concerns the effect of various systemic conditions on the oral cavity and conversely helps to diagnose various systemic conditions.