Miracle-dz/UniFAR-FTUs huggingface dataset:
Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report

Copyright © National Academy of Sciences. Permission is granted for this material to be shared for noncommercial, educational purposes, provided that this notice appears on the reproduced materials, the Web address of the online, full authoritative version is retained, and copies are not altered. To disseminate otherwise or to republish requires written permission from the National Academies Press. ISBN: 0-309-14431-0, 160 pages, 8 1/2 x 11, (2009)
Ultra-Short Stems with Proximal Load Transfer: Clinical and Radiographic Results at Five-Year Follow-Up

Bone stock preservation is crucial when performing THR in young patients. Following this philosophy, an original ultra-short custom-made implant with extensive proximal load transfer was developed. It presents three very innovative features: absence of the diaphyseal portion of the stem, a well defined lateral flare with load transfer on the lateral column of the femur and a very high femoral neck cut. These innovations resulted in a very conservative implant both of the bone stock and the soft tissues. In this study we reviewed the X-rays of 111 patients with 131 primary total hip replacements performed with this implant. The average pain score using the Harris Hip Score system, at an average of five years after surgery, was 42 of 44 points; 95 per cent (124) of the patients had no or slight pain. We had no cases of thigh pain. None of the patients required a femoral stem revision. Two cases had to be re-operated for polyethylene liner exchange but the femoral implant was stable and left in place. At five years, all implants appeared radiographically stable with well maintained proximal bone stock. It was concluded that the geometry of this implant provides significant initial stability, which seems to be preserved throughout a long follow-up period. This study validates the assumption that torsional loads can be controlled even without the diaphyseal portion of the stem and that neck preservation combined with lateral flare support guarantees a more natural loading of the femur. (Hip International 2006; 16 (suppl 3): S31-9)
Semi-synthesis of triterpene A-ring derivatives from oleanolic and maslinic acids. Part II. Theoretical and experimental 13C chemical shifts†

Maslinic acid was obtained from olive-pressing residues, and several derivatives were formed. Rearrangements of 2-tosyloxy-derivatives of methyl maslinate made out by acetolysis. The main product of these rearrangements contained a cyclopentanic A-ring as a result of a concerted 2(3) → 4-abeo rearrangement process. Experimental and theoretical (GIAO, B3LYP/6-31G*//MM+) 13C NMR chemical shifts for 20 compounds are given.
Uncemented stems in hip replacement - hydroxyapatite or plain porous: Does it matter? Based on a prospective study of HA Omnifit stems at 15-years minimum follow-up

For many years, acrylic cement has been regarded as the unique available means for a long term and secure fixation of components in hip arthroplasty. A new generation of uncemented implants coated in hydroxyapatite (HA) has arisen since the mid-1980s, aiming to provide a “biological interface” between metal and surrounding bone, and thus the hydroxyapatite interface was defined some years ago as a distinct entity from both cemented and “plain porous” fixation. Based upon our 20-year experience with the HA Omnifit stem, this paper aims to discuss the efficiency of hydroxyapatite as a means of fixation for femoral components in hip arthroplasty, then examine whether the addition of a calcium phosphate layer induces any adverse effects, and finally make comparisons between HA-coated versus porous hip stems reported in the literature. With respect to fixation of femoral components in hip arthroplasty we report excellent results from the partially coated HA Omnifit stem in our series, with 99.20% of survival rate at 17-year follow-up, these results being consistent and similar to other HA series in the literature. HA “uncemented” fixation can therefore be considered reliable and efficient. Furthermore, two decades of hydroxyapatite coatings have resulted in the identification of no major adverse effects. In fact calcium phosphate ions participate in the physiological turn-over of bone remodelling, and the HA coating is replaced by new bone formation without any fibrous tissue layer. Since HA particles are biodegradable and do not produce any inflammatory reaction in the surrounding bone, fears of osteolysis or third body wear due to HA debris have not been confirmed. Finally, comparison between HA versus plain porous femoral components through the literature has demonstrated better results with HA than porous alone both in terms of the quantity and quality of bone remodelling, and the potential migration and subsidence of the stem.
Inequality of Health Spending and Public Health Outcome in Countries of the WHO’s Eastern Mediterranean Regional Office (EMRO)

Introduction: There are little attention about health spending and public health outcomes especially in the WHO’s Eastern Mediterranean Region. This paper presents an overview on health spending and public health outcomes in the WHO Eastern Mediterranean countries during 1995-2011. Methods: This study conducted in 2013 use of health expenditure and public health outcome of 19 WHOs Eastern Mediterranean Region countries during 17 years (1995-2011). Data were including: Per capita health expenditure in current US dollar, Life expectancy at birth, Infant Mortality Rate per 1,000 live births, Under-5 years Mortality Rate per 1,000 live births. Data collected from the latest World Bank published data until 2013. The Descriptive statistics were used to study by using Excel 2007. Results: In this region, the minimum spending on health (by Pakistan) was about 60 times less than maximum spending (by Qatar). Maximum amount of infant and children mortality rate were respectively 9 and 10 times more than the minimum. Also a decreasing returns to scale of health spending seen between countries. So that countries with better public health status need to pay much more than countries with poor public health status to increase 1 year life expectancy or to save 1 infant or child from premature death. Conclusion: There is a large inequality among countries of the WHO Eastern Mediterranean region in both health spending and public health outcomes. Due to a decreasing return to scale, allocation financial aids to countries with poor health status can help converging health status in the region and decrease inequalities.
Intimate Partner Violence against Women in Dubai: Prevalence, Associated Factors and Health Consequences, 2012-2013

Background: Intimate partner violence against women (IPVAW) (physical, psychological, or sexual abuse) is one of the most common forms of gender based violence. Objectives: to measure the prevalence, severity and type of IPV experienced by ever married women, to identify some sociodemographic and behavioral risk factors for IPV and to study some physical and mental health consequences associated with
Effect of Post-Prandial Exercise Duration on Glucose and Insulin Responses to Feeding

PURPOSE Obesity is reaching an alarming incidence. In the United States alone 55% women and 63% of men over the age of 25 are either over weight or obese (Must et al. , 1999). Due to the rising incidence of obesity in developed countries there has been an increase in interest in the health effects of obesity. Sedentary living and high carbohydrate intake have been found to lead to insulin resistance and compensatory hyperinsulinemia, even when blood glucose concentrations remain normal (Foster-Powel and Miller, 1995). Sedentary living, high carbohydrate intake and the resulting hyperinsulinemia may be the common link between sedentary living and obesity on the one hand and the rising incidence of “diseases of civilization” including: hypertension, obesity, coronary disease, and type 2 diabetes on the other hand (Chakravarthy and Booth 2004, Reaven, 1988; DeFronzo and Ferrannini, 1991; Reaven, 1994). Hyperinsulinemia has also been suggested as a causative link to a variety of conditions or diseases such as acne, early menarche, increased stature, myopia, skin tags, polycystic ovary syndrome, male vertex balding and epithelial cell ( breast, prostate, etc.) carcinomas (Cordain, 2003). Chronic exercise has been shown to increase insulin sensitivity and decrease hyperinsulemia. Increased muscle stimulation leads to an increase of glucose absorption due to increased membrane permeability (Ivy, 1987). It has been suggested that exercise increases the amount of insulin-responsive glucose transporters and other enzymes that control transport, storage, and oxidation of glucose (Ivy, 1987). Increases of glucose uptake lowers blood glucose, resulting in a decrease in insulin release. In sedentary individuals the reduced number of insulin sensitive glucose transporters leads to a larger insulin concentration necessary to maintain normal blood glucose concentrations (e.g. hyperinsulinemia) Glucose concentration tends to spike after eating a meal. However it has been found that exercise can also act acutely to regulate glucose and reduce the amount of insulin necessary to manage the glucose load from a meal. A recent study from our laboratory demonstrated the effects of moderate intensity post-prandial exercise on glucose and insulin responses (Foster, 2002). That study demonstrated that exercise moderates glucose and insulin responses to a meal, but that the effects of exercise are short lived and the levels of glucose and insulin increased following exercise. In view of the simplicity of recommending post prandial exercise as a strategy for controlling hyperglycemia and hyperinsulinemia, the purpose of the present study was to determine if the magnitude of glycemic and insulinemic control was responsive to the duration of post-prandial exercise.
Monografia Contagem de Hidratos de Carbono Carbohydrate Counting

Diabetes is a metabolic disease in which a chronic elevation of the blood glucose concentration is verified . Nutritional Therapy is essential for the self-control and management of the disease. The carbohydrate counting is one of the meal-planning tools used in patients with Diabetes that focuses the carbohydrate as the most important in the postprandial glycemic response. Trough this method, patients with Diabetes are taught to do an estimation of the content of carbohydrate in their meal. This method can be used both in patients with diabetes type 1 or type 2 to maintain a consistent ingestion of carbohydrate, or to, combined with intensive insulin treatment, increase the ingestion flexibility, maintaining the glycemic control. In Portugal, there are different counting methodologies in use, according with the different diabetes centers. The diabetic associations and the scientific and academicals associations should suggest uniform methodologies that will smooth the progress of the method implementation, and the work methods homogenization, in order to accomplish a bigger accuracy and improvement. The nutritionist is essential, as part of a multidisciplinary team, in the diabetic therapeutic education. To educate is more than to give concepts and techniques; it demands time, availability, an individualized intervention, that helps increasing the patient’s responsibility and more liberty of choice.
Trends in the numbers of one-parent families in Great Britain.

This article presents new estimates of the number of one-parent families--and dependent children living in them--in Great Britain in 1990 provisional estimates for 1991 and revised estimates for 1989.The article examines the trends in the numbers and the composition of one-parent families over the last two decades. Between 1971 and 1991 the number of one-parent families more than doubled including an increase of one quarter during the last four years up to 1991. During the same four-year period the number of single lone parents grew even more quickly increasing by almost three quarters. (EXCERPT)
Editor's Notes

The prolonged partisan and totally optional squabble over the federal debt ceiling increase consumed the U.S. Congress for most of the spring and summer and finally ended (for now) on August 2, 2011, when the Republican-controlled House of Representatives agreed to terms and President Obama signed the increase into law. Just to clarify, increasing the debt ceiling does not obligate the government to spend more money; it allows the government to pay the bills on liabilities Congress had already committed to spend on existing programs. The debt ceiling has been increased 73 times in the past 50 years without this kind of squabble. To the dismay of the rest of the world, the squabble lasted too long, and on August 5, Standard and Poor’s downgraded the creditworthiness of the United States government and caused a stock crash that resulted in a drop of 634 points on the Dow Jones Industrial Average the following Monday, August 9. This was the sixth largest drop ever in 1 day and occurred after more than a week of declines caused by fiscal problems in Europe. Losses for the month of August were the worst for a month since the big stock market crash of 2008. How far values will climb back remains unknown. The smart money fled equity stocks and flooded the safest investment on the planet.U.S. Treasury securities (backed, of course, by the U.S. government, whose credit worthiness had just been downgraded). Standard and Poor’s primary concern was not the current budget deficit or total federal debt. Their primary concern was the same as any citizen who follows this issue closely: that the federal government has become dysfunctional because of partisan histrionics and may be incapable of putting its fiscal house in order. Despite the havoc wreaked on the world (and my retirement savings), this squabble made one thing very clear to the public: Current U.S. fiscal policy is not sustainable. The purpose of this article is to illustrate how more comprehensive health promotion programs may be able to substantially reduce the federal deficit and in doing so, create thousands of new jobs. I start by explaining the federal deficit and budget crisis in more detail, making the case that improving the health status of the population is the best option for solving this crisis, and describing what we need to do to improve health, including how we can raise $62 billion a year to fund health promotion programs provided through all sectors of society. I offer this as a straw man. I expect and hope that people will think of more sophisticated ways to analyze the financial relationships and more effective strategies to achieve the proposed goals. I look forward to seeing those ideas and incorporating them into a better approach.
A District General Hospital'S Experience of Hip Resurfacing

In our unit 180 consecutive hip resurfacing procedures have been performed. All patients had a posterior approach to the hip joint, followed by standard resurfacing using metal-on-metal components. The patients were evaluated radiographically and clinically preoperatively and postoperatively. The mean age of patients was 56 years (range 25-75). There was a statistically significant improvement between the preoperative Harris Hip Score and those at the latest follow-up. There were four fractures of the femoral neck; one was intra-operative and was converted to total joint arthroplasty. Three further fractures occurred: two were revised and one was treated non-operatively. There were no cases of dislocation or deep infection. The shortand medium-term results that have been achieved in this district general hospital are comparable to those that have been achieved in the originator’s institution. (Hip International 2007; 17: 1-3)
Obésité et grossesse : mode d'accouchement des patientes obèses = Obesity and pregnancy : delivery outcome in obese patients

Objectif : Etudier les effets de l'obesite maternelle sur le mode d'accouchement et la survenue de complications perinatales. Materiel et methodes : Etude de cohorte historique, incluant toutes les patientes avec un indice de masse corporel (IMC) superieur a 30 ayant accouche a l'Hopital Couple-Enfant (HCE) entre le 1er janvier et le 31 decembre 2009, a l'exclusion des grossesses gemellaires, des morts foetales in utero et interruptions medicales de grossesse. Deux groupes sont constitues selon l'IMC : inferieur a 35 (classe I) et superieur a 35 (classe II). Les caracteristiques epidemiologiques, les complications obstetricales, le travail et ses complications, les issues neonatales et du post-partum ont ete analysees. Resultats : Au cours de cette annee, 64,4% (139/216) des patientes etaient dans la classe I et 35,7% (77/216) appartenaient a la classe II. Les diabetes preexistants et gestationnels insulino-dependants etaient significativement plus frequents dans la classe II (p < 0,05), ainsi que les declenchements, complications du travail (telles que anomalies du rythme cardiaque foetal, liquide amniotiques meconiaux) et cesariennes apres declenchement (37,8 vs 17,9% ; p < 0,05). Nous ne retrouvions pas de difference pour ce qui est du mode d'accouchement. Discussion et conclusion : Notre etude montre que l'obesite a un impact pejoratif sur le pronostic perinatal, d'autant plus quand la grossesse est compliquee d'un diabete gestationnel, mais sans pour autant modifier le mode d'accouchement.
Total Hip Replacement in High Riding Developmental Dysplasia of the Hip: Cementless Total Hip Arthroplasty with Femoral Shortening Using a Subtrochanteric Resection

Total hip arthroplasty in younger patients with high riding dislocations is a challenging procedure. Although many procedures have been proposed, our preferred technique for this is to insert a small sized cementless acetabular component in the native acetabulum, a small sized cementless femoral component and perform a subtrochanteric oblique cylindrical resection of 4 centimeters. The femur is fixed with a plate using unicortical screw fixation. This technique is preferred to avoid stretching the neurovascular structures. This procedure was performed on 91 hips of 83 patients with a mean age of 45 years, between 1990 and 2005. After 8 years we observed a 10% failure with a good clinical outcome. The Merle d'Aubigne Hip Scores were improved from 10.65 preoperatively to 34.95 postoperatively. Despite a high complication and failure rate the patients were pleased with the final outcome. We continue to recommend this procedure in this unique patient population.
Unusual Clot Formation following Insertion of Central Double Lumen Catheter for Hemodialysis

Background: We report a case of a patient with chronic renal failure (CRF) due to fibrillary glomerulonephritis, who was admitted to our Hospital with fever accompanied by chills, of two days duration. Due to aggravation of his CRF, accompanied by severe metabolic acidosis, an internal jugular double lumen central vein catheter was inserted, through which he was hemodialyzed. Methods: Blood cultures were negative. The catheter was removed and the tip was cultured; it revealed colonization with hemolytic Staphylococcus sensitive to vancomycin and metilmycin. They were both given to the patient with excellent results. Trans-thoracic and trans-esophageal echocardiography revealed a clot in the right atrium with an abnormal circumference, connected to the tip of the second catheter. Anticoagulants were administered (calsium nadroparin, converted seven days later to acenocoumarol) and the size of the clot was significantly reduced. Results: The case is presented in order to prove the significant contribution of trans-esophageal echocardiography as a non-invasive imaging technique for the detection of a clot in the right atrium and the impressive influence of appropriate therapeutic management in saving the patient's life and reducing the clot size. Conclusions: The trans-esophageal echocardiogram provides invaluable information concerning the evolution, development and regression of right atrium clots formed at the tip of jugular catheters. (The Journal of Vascular Access 2003; 4: 160-3)
L'importance de l'attitude ludique en ergothérapie avec une clientèle adulte

Description. Comme l'attitude ludique demeure peu documentée chez l'adulte, son potentiel thérapeutique est incertain. But et méthodologie. Une démarche qualitative mène à l'élaboration d'un modèle conceptuel de l'attitude ludique à l'âge adulte qui permettra de discuter de son utilisation possible en ergothérapie. Résultats. Le modèle identifie les sources d'influences et les conséquences de l'attitude ludique chez l'adulte. Les conséquences identifiées rejoignent à la fois la modalité privilégiée en ergothérapie, soit l'activité significative, et les objectifs d'intervention soit la capacité d'agir, la santé et le bien-être. Pour ces raisons, le modèle proposé présente un potentiel intéressant pour l'intervention ergothérapique. Conséquences pour la clinique. Ce modèle conceptuel présente une vision unique et innovatrice de l'attitude ludique à l'âge adulte qui ouvre une nouvelle voie pour l'activité significative. Il suggère que l'attitude ludique pourrait devenir un outil important en ergothérapie pour développer la capacité d'agir. Il propose ainsi une façon innovatrice d'aborder le client.
Managing depression in primary care

obJEctiVE To investigate family physicians’ practice patterns for managing depression and mental health concerns among adolescent and adult patients. dEsiGn Cross-sectional survey. sEttinG London, Ont, a mid-sized Canadian city. participants One hundred sixty-three family physicians identified through the London and District Academy of Medicine. Main oUtcoME MEasUrEs Practice patterns for managing depression, including screening, pharmacotherapy, psychotherapy, shared care, and training needs. rEsULts Response rate was 63%. Family physicians reported spending a substantial portion of their time during patient visits (26% to 50%) addressing mental health issues, with depression being the most common issue (51% to 75% of patients with mental health issues). About 40% of respondents did routine mental health screening, and 60% screened patients with risk factors for depression. Shared care with mental health professionals was common (care was shared for 26% to 50% of patients). Physicians and patients were moderately satisfied with shared care, but were frustrated by long waiting lists and communication barriers. Most physicians provided psychotherapy to patients in the form of general advice. Differences in practice patterns were observed; physicians treated more adults than adolescents with depression, and they reported greater comfort in treating adults. Although 33% of physicians described using cognitive behavioural therapy (CBT), they reported having little training in CBT. Moderate interest was expressed in CBT training, with a preference for a workshop format.
Chondromalacia Coxae

A new arthroscopic finding of chondromalacia of the femoral head is reported in five patients undergoing hip arthroscopy for undiagnosed hip pain. The term chondromalacia coxae is used to describe the condition, and its similarity to chondromalacia patellae is discussed. (Hip International 1995; 5: 121-3)