Miracle-dz/UniFAR-FTUs huggingface dataset:
Cardiovascular risk factors in Turkish immigrants with type 2 diabetes living in the Netherlands

This study examined the associations of serum cotinine and serum 25hydroxyvitamin D with blood pressure and serum lipids in Turkish immigrants with type 2 diabetes (T2D) living in the Netherlands. A total of 110 participants, physiciandiagnosed with T2D, aged 30 years and older were recruited from multiple sources from The Hague, Netherlands. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using an automated office blood pressure equipment. Serum cotinine was measured with a solid-phase competitive chemiluminescent immunoassay. Serum 25-hydroxyvitamin D was determined by electrochemiluminescence immunoassay (ECLIA). Serum lipids were determined by enzymatic assay and included total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL), low-density lipoprotein (LDL), and triglycerides (TG). Total cholesterol to HDL ratio (CHOL:HDL) and atherosclerosis-index (AI) were calculated. Statistical analysis included descriptives and multiple linear regressions. High cotinine levels (≥ 25 ng/mL), as a biomarker for smoke exposure, were associated with high CHOL:HDL ratio (B= 0.59, SE= 0.28, P<0.05) and high AI (B= 0.59, SE= 0.28, P<0.05). Low 25-hydroxyvitamin D levels (< 25 nmol/L) were associated with low DBP (B= -4.14, SE= 2.00, P<0.05). Environmental influences including smoking and vitamin D need to be further investigated in the Turkish immigrant population. Serum cotinine and vitamin D may be assessed as a standard of care for T2D management in the Turkish immigrant population.
Vaspin: a novel serpin with insulin-sensitizing effects

Background: A variety of substances, including free fatty acids, leptin, tumor necrosis factor-α, acylation-stimulating protein, adiponectin, and resistin, are secreted by adipocytes. They modulate insulin sensitivity and are new therapeutic targets in metabolic syndrome. Objective: To identify novel adipokines derived from visceral adipose tissues. Method: We used the PCR-based cDNA subtraction method to screen the genes predominantly expressed in visceral white adipose tissues (WATs) in Otsuka Long-Evans Tokushima fatty (OLETF) rats, an animal model of abdominal obesity and type 2 diabetes. Results/conclusions: We identified the vaspin gene (Serpina12) which is upregulated in visceral WATs of OLETF rats. Vaspin mRNA was barely detectable at 6 weeks of age and it was abundantly and exclusively expressed in visceral WATs at 30 weeks of age, when OLETF rats reach their peak body weight. However, vaspin mRNA decreased with worsening of diabetes and body weight loss. Vaspin mRNA increased with treatment of thiazolidinediones (pioglitazone). Administration of recombinant vaspin into high-fat high-sucrose chow-induced obese ICR mice improved glucose tolerance and insulin sensitivity. Vaspin may be the compensatory molecule in the pathogenesis of metabolic syndrome and vaspin recombinant protein or vaspin-mimicking agents such as vaspin analogs, antibodies or small molecule agents may be the link to drug discovery and development.
Community health-promotion interventions with physical activity: does this approach prevent obesity?

Background: Prevention of weight gain is a primary strategy in tackling the obesity epidemic. Objective: This review summarizes results of community interventions for prevention of cardiovascular diseases, with dietary changes and increased physical activity as target behaviours, and change in obesity as one outcome variable. Design: A Medline search was used to identify studies. The focus behaviour was physical activity, but all of the five selected interventions also had dietary changes as an essential component. Results: The interventions were aimed at prevention of cardiovascular diseases, and all had dietary changes, increased physical activity and decreased prevalence of obesity as means to achieve the main objective. The duration of intervention was 4–7 years. Out of the four projects with physical activity assessments, two did not observe any significant intervention effects on physical activity. The residents of the intervention communities of the Minne sota Heart Health Study were somewhat more physically active at the end of the follow-up. In the Stanford Five-City Project, the intervention had a positive effect on physical activity in independent, cross-sectional samples. Most projects did not find any intervention impact on body mass index (BMI). In the Stanford Five-City Project, BMI increased less in treatment than in control communities, but this effect was observed only by using the cross-sectional, independent surveys. Conclusion: It seems that the increase in energy expenditure due to physical activity was not large enough. To enable improvements, future interventions may need a stronger emphasis on changes in the local physical and social environment. Keywords: Cardiovascular diseases, eating, environment, exercise, overweight.
Control Software Synthesis and Validation for a Vehicular Electric Power Distribution Testbed

Modern aircraft increasingly rely on electric power, resulting in high safety criticality and complexity in their electric power generation and distribution systems. Motivated by the resulting rapid increase in the costs and duration of the design cycles for such systems, the use of formal specification and automated correct-by-construction control protocols synthesis for primary distribution in vehicular electric power networks is investigated. A design workflow is discussed that aims to transition from the traditional “design and verify” approach to a “specify and synthesize” approach. An overview is given of a subset of the recent advances in the synthesis of reactive control protocols. These techniques are applied in the context of reconfiguration of the networks in reaction to the changes in their operating environment. These automatically synthesized control protocols are also validated on high-fidelity simulation models and on an academic-scale hardware testbed.
Dutch DisMod. Constructing a set of consistent data for chronic disease modelling

Om te komen tot consistente verzamelingen van invoergegevens voor dynamische modellen van chronische ziekten hebben we de consistentie binnen de modelcontext geanalyseerd van gegevens over incidentie, prevalentie en sterfte voor specifieke ziekten. Dergelijke modellen integreren gegevens uit verschillende bronnen en worden gebruikt om de volksgezondheids-effecten van trends in en interventies op risicofactoren door te rekenen. Incidentie- en prevalentie-gegevens komen uit huisartsenregistraties, epidemiologische onderzoeken en registraties in de gezondheidszorg, gegevens over overleving uit de wetenschappelijke literatuur, terwijl ziekte-specifieke sterftecijfers uit de CBS-statistieken komen. De opeenvolgende analysestappen zijn: 1) een vergelijking van de gegevens uit verschillende bronnen, 2) de berekening van remissie- en sterfterates uit gegeven incidentie- en prevalentierates, vervolgens 3) een vergelijking met data uit de literatuur. We hebben data ge6valueerd met betrekking tot longkanker, astma en COPD, coronaire hartziekten en hartfalen, diabetes mellitus, dementie, en beroerte. Verschillende algemene conclusies kunnen getrokken worden: de gevonden verschillen tussen de bronnen zijn meestal terug te vertalen naar verschillen in registratiekarakteristieken; voor veel aandoeningen is de berekende 'excess' sterfte veel groter dan de sterfte met de ziekte als de primaire doodsoorzaak in de CBS-statistieken; de geschatte sterfteparameters komen in de meeste gevallen goed overeen met die uit de literatuur; de aanwezigheid van trends in de tijd maakt het schatten van leeftijd-specifieke cijfers lastig.
Breast screening with magnetic resonance imaging

See also practice article by Warner and colleagues at [www.cmaj. ca/lookup/doi/10.1503/cmaj.120392][1] The availability of MRI as a supplementary examination to mammography offers a clear clinical benefit to some women at high risk for breast cancer. [1][2]–[5][3] In a meta-analysis of 11 studies,
Wait times in the emergency department for patients with mental illness

Background: It has been suggested that patients with mental illness wait longer for care than other patients in the emergency department. We determined wait times for patients with and without mental health diagnoses during crowded and noncrowded periods in the emergency department. Methods: We conducted a population-based retrospective cohort analysis of adults seen in 155 emergency departments in Ontario between April 2007 and March 2009. We compared wait times and triage scores for patients with mental illness to those for all other patients who presented to the emergency department during the study period. Results: The patients with mental illness (n = 51 381) received higher priority triage scores than other patients, regardless of crowding. The time to assessment by a physician was longer overall for patients with mental illness than for other patients (median 82, interquartile range [IQR] 41–147 min v. median 75 [IQR 36–140] min; p < 0.001). The median time from the decision to admit the patient to hospital to ward transfer was markedly shorter for patients with mental illness than for other patients (median 74 [IQR 15–215] min v. median 152 [IQR 45–605] min; p < 0.001). After adjustment for other variables, patients with mental illness waited 10 minutes longer to see a physician compared with other patients during noncrowded periods (95% confidence interval [CI] 8 to 11), but they waited significantly less time than other patients as crowding increased (mild crowding: −14 [95% CI −12 to −15] min; moderate crowding: −38 [95% CI −35 to −42] min; severe crowding: −48 [95% CI −39 to −56] min; p < 0.001). Interpretation: Patients with mental illness were triaged appropriately in Ontario’s emergency departments. These patients waited less time than other patients to see a physician under crowded conditions and only slightly longer under noncrowded conditions.
Changes in maternal lipid peroxidation levels and antioxidant enzymatic activities before and after delivery.

Objective: Our goal was to characterize the changes in maternal lipid peroxidation levels and antioxidant enzymatic activities before and after delivery. Methods: Predelivery and 124 and 48 hours post‑partum plasma concentrations of malon‑ dialdehyde erythrocyte enzyme superoxide dismutase glutathione peroxidase and catalase were measured in uncomplicated pregnancies. Results: Malondialdehyde levels increased slightly from predelivery to 24 hours post‑partum and then decreased significantly at 48 hours post‑partum. At one hour post‑partum superoxide dismutase and catalase levels increased significantly to about 125% and 170% of predelivery lev‑ els respectively. Thereafter these values decreased significantly from one hour to 48 hours post‑ partum. The relative changes in superoxide dismutase and catalase levels at one hour post‑ partum compared to predelivery values correlated significantly with the duration of labor. Conclusion: The results suggest that the uncontrolled lipid peroxidatio nc aused by reactive oxygen species which are produced in consequence of tissue reoxygenation may occur during labor and that prolonged labor may cause maternal oxidative stress. (J Nippon Med Sch 2000; 67: 434―439)
The Value of Surrogate Endpoints for Evaluation of Therapeutic Efficacy

Pivotal trials on morbidity and mortality (eg, in coronary heart disease, AIDS, cancer) are not only desirable but also necessary for definitive corroboration of new therapies. Since the immense investment and long duration of such trials frequently make it impossible to await the results and use them as the decisive criteria for registration of new and innovative therapeutic principles, however, scientific recognition has also been granted to study designs in which the surrogate endpoint is substituted as a target variable for the definitive clinical endpoint. The problems associated with these therapeutic trials based on surrogate endpoints will be discussed by means of positive and negative examples, citing examples of drug development processes for which clearance for new medicines or indications has been granted on the basis of surrogate endpoints which generally exhibited a positive-positive relationship. There are also examples, however, of positive-negative relationships for surrogate endpoints and clinical endpoints. An attempt will be made to describe the limitations and the appropriate role of surrogate endpoints.
Is Clostridium difficile infection still a problem for hospitals?

See related research article by Forster and colleagues on page [37][1] and at [www.cmaj. ca/lookup/doi/10.1503/cmaj.110543][2] Clostridium difficile is the most common cause of hospital-acquired infectious diarrhea in the developed world and has re-emerged in recent years with apparent greater
Statistical Analysis of Risk Factors for Cardiovascular Disease in Malakand Division

Several studies have been conducted to investigate the incidence of cardiovascular disease and to determine the possible risk factors for the disease. In this study, a Statistical method of odds ratio analysis was performed to look at the association of one of the type of cardiovascular disease known as myocardial infarction with various risk factors such as diabetes, cholesterol, hypertension, sex, smoking, obesity, family history and age in Malakand division. A total of 700 patients were examined and their personal and medical data were collected. For each patient, the phenomenon of myocardial infarction was studied in relation to different risk factors. The analyses suggest that hypertension, smoking, diabetes, cholesterol level and family history were important risk factors for the occurrence of myocardial infarction.
CD4-T-Lymphocyte Reference Ranges in Uganda and Its Influencing Factors

Background: Given the importance of CD4-T-lymphocyte monitoring in HIV/ART management, we established CD4/CD8 reference ranges in Uganda and studied factors associated with CD4/CD8 in a normal population. Methods: Blood samples for 206 HIV seronegative healthy volunteers from the Mbarara and Kampala districts in Uganda were analyzed using the PanLeucogating protocol. Results: The reference ranges reported include data from 172 participants with no current or serious recent health problems. The 95% reference ranges for absolute CD4 (ACD4) count was 418-2105 cells/µL, 2561619 for absolute CD8 count, and 0.52-4.1 for CD4/CD8 cell ratio, which is wider than the reference ranges currently used in Uganda. Recent illnesses/medications and sociodemographic factors affected the CD4T-lymphocyte count. Conclusion: The CD4 reference ranges in Uganda were established using a cost-effective method, recommended and available in resource-limited settings. Effect of prevalent infections and socio-demographic differences on CD4-T-lymphocyte levels would need consideration in HIV/ART clinical management.
ST-elevation myocardial infarction: Is there time for Q waves?

See related research article by Siha and colleagues on page [1135][1] and at [www.cmaj. ca/lookup/doi/10.1503/cmaj.111683][2] Acute myocardial infarction (MI) is a leading cause of morbidity and mortality. A common type of MI is ST-segment elevation myocardial infarction (STEMI). [1][3] During STEMI
Medical interventions to reduce motor vehicle collisions

Trauma caused by motor vehicle collisions is a common cause of death, accounting for more than 3000 deaths each day worldwide (about 7 of which occur in Canada). [1][1] For each person who dies, an additional 80 people sustain injuries and 300 suffer financial losses. [2][2] Trauma from motor vehicle
Iron deficiency in early childhood

An 18-month-old girl is seen by her family physician for her 18-month check-up. Her weight and height are at the 50th percentile. She was breastfed in the first year, introduced to complementary (i.e., solid) foods at 6 months and cow’s milk at 12 months, and currently drinks 1 L of cow’s milk
DAY HOSPICE CARE: PERCEPTIONS AND TABOOS IN PALLIATIVE CARE

Stimulated by Downs(2003) article on Failure in Palliative Care the author reflects on the workings of a day hospice focusing on the difficult and challenging issues for patients and how the hospice setting can enable these issues to be raised and addressed. The issues are explored and illustrated using patient comments and experiences. Acknowledging a dearth of hospice day care research and literature the author seeks to motivate others and encourage a wider appreciation of day hospice and thereby influence future practice.
Association between sonographic morphology of vastus medialis obliquus and patellar alignment in patients with patellofemoral pain syndrome.

STUDY DESIGN Descriptive, correlational, anatomical laboratory study. OBJECTIVES To investigate the association between the morphology of the vastus medialis obliquus (VMO) and patellar alignment in patients with patellofemoral pain syndrome (PFPS). BACKGROUND It has long been presumed that PFPS results from patellar malalignment. Strengthening of the VMO has been suggested as an intervention to treat individuals with PFPS, through correction of abnormal patellar tracking. However, the exact role of the VMO in the etiology and treatment of PFPS is not clear. METHODS AND MEASURES This study included 58 patients with PFPS, of which 31 had bilateral involvement. A total of 89 knees were imaged with a Merchant's view radiograph at 45 degrees of knee flexion to measure patellar alignment consisting of patellar tilt and congruence angles. Those 89 knees were also examined with sonography with the knee in full extension and quadriceps relaxed to measure VMO morphology and additional characteristics such as insertion level, insertion ratio, fiber angle, and volume. The level of association between radiographic and sonographic measurements was explored to determine any relationship between patellar alignment and morphology of the VMO. RESULTS The patellar tilt angle was negatively correlated with the VMO insertion level (r = -.58, P<.05), insertion ratio (r= -.52, P<.05), and volume (r = -.45, P<.05). In addition, the patellar congruence angle was negatively correlated with the VMO fibers angle (r = -.23, P<.05). CONCLUSIONS This study showed that some aspects of VMO morphology, measured in full knee extension with the quadriceps relaxed, were associated with patellar alignment measured with the knee at 45 degrees of flexion. Whether or not VMO morphology serves as a predictor of patella alignment with the knee extended should be the focus of future investigations.
Diagnosis and management of a patient with knee pain using the movement system impairment classification system.

STUDY DESIGN Case report. BACKGROUND Selecting the most effective conservative treatment for knee pain continues to be a challenge. An understanding of the underlying movement system impairment that is thought to contribute to the knee pain may assist in determining the most effective treatment. Our case report describes the treatment and outcomes of a patient with the proposed movement system impairment (MSI) diagnosis of tibiofemoral rotation. CASE DESCRIPTION The patient was a 50-year-old female with a 3-month history of left anteromedial knee pain. Her knee pain was aggravated with sitting, standing, and descending stairs. A standardized clinical examination was performed and the MSI diagnosis of tibiofemoral rotation was determined. The patient consistently reported an increase in pain with activities that produced abnormal motions or alignments of the lower extremity in the frontal and transverse planes. The patient was educated to modify symptom-provoking functional activities by restricting the abnormal motions and alignments of the lower extremity. Exercises were prescribed to address impairments of muscle length, muscle strength, and motor control proposed to contribute to the tibiofemoral rotation. Tape also was applied to the knee in an attempt to restrict tibiofemoral rotation. OUTCOMES The patient reported a cessation of pain and an improvement in her functional activities that occurred with correction of her knee alignment and movement pattern. Pain intensity was 2/10 at 1 week. At 10 weeks, pain intensity was 0/10 and the patient reported no limitations in sitting, standing, or descending stairs. The patient's score on the activities of daily living scale increased from 73% at the initial visit to 86% at 10 weeks and 96% at 1 year after therapy was discontinued. DISCUSSION This case report presented a patient with knee pain and an MSI diagnosis of tibiofemoral rotation. Diagnosis-specific treatment resulted in a cessation of the patient's pain and an improved ability to perform functional activities.
The State of Homelessness in Canada 2013

The author's rights re this report are protected with a Creative Commons license that allows users to quote from, link to, copy, transmit and distribute for non-commercial purposes, provided they attribute it to the authors and to the report. The license does not allow users to alter, transform, or build upon the report. More details about this Creative Commons license can be viewed at
The immediate effects of atlanto-occipital joint manipulation and suboccipital muscle inhibition technique on active mouth opening and pressure pain sensitivity over latent myofascial trigger points in the masticatory muscles.

DESIGN A randomized controlled trial. OBJECTIVE To investigate the immediate effects on pressure pain thresholds over latent trigger points (TrPs) in the masseter and temporalis muscles and active mouth opening following atlanto-occipital joint thrust manipulation or a soft tissue manual intervention targeted to the suboccipital muscles. BACKGROUND Previous studies have described hypoalgesic effects of neck manipulative interventions over TrPs in the cervical musculature. There is a lack of studies analyzing these mechanisms over TrPs of muscles innervated by the trigeminal nerve. METHODS One hundred twenty-two volunteers, 31 men and 91 women, between the ages of 18 and 30 years, with latent TrPs in the masseter muscle, were randomly divided into 3 groups: a manipulative group who received an atlanto-occipital joint thrust, a soft tissue group who received an inhibition technique over the suboccipital muscles, and a control group who did not receive an intervention. Pressure pain thresholds over latent TrPs in the masseter and temporalis muscles, and active mouth opening were assessed pretreatment and 2 minutes posttreatment by a blinded assessor. Mixed-model analyses of variance (ANOVA) were used to examine the effects of interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. RESULTS The 2-by-3 mixed-model ANOVA revealed a significant group-by-time interaction for changes in pressure pain thresholds over masseter (P<.01) and temporalis (P = .003) muscle latent TrPs and also for active mouth opening (P<.001) in favor of the manipulative and soft tissue groups. Between-group effect sizes were small. CONCLUSIONS The application of an atlanto-occipital thrust manipulation or soft tissue technique targeted to the suboccipital muscles led to an immediate increase in pressure pain thresholds over latent TrPs in the masseter and temporalis muscles and an increase in maximum active mouth opening. Nevertheless, the effects of both interventions were small and future studies are required to elucidate the clinical relevance of these changes. LEVEL OF EVIDENCE Therapy, level 1b.J Orthop Sports Phys Ther 2010;40(5):310-317, Epub 12 April 2010. doi:10.2519/jospt.2010. 3257.