Miracle-dz/UniFAR-FTUs huggingface dataset:
Expulsion and continuation rates after postabortion insertion of framed IUDs versus frameless IUDs – review of the literature

Background Early intrauterine device (IUD) discontinuation after insertion immediately following aspiration abortion or after early medical abortion occurs as a consequence of expulsion of the IUD or removal due to side effects. These are often the consequence of the uterine forces impacting on the IUD due to spatial discrepancy with the uterine cavity causing pain, abnormal bleeding, and eventually, removal of the IUD. These women are candidates for repeat pregnancy as they often select less-effective methods or no contraception at all. Repeat abortion could be reduced by giving attention to these factors. Study design In order to have an indication on the magnitude of the problem of IUD expulsion or discontinuation, we searched the MEDLINE database for clinical trials, randomized controlled trials, and prospective observational studies related to immediate postaspiration termination of pregnancy (TOP) and early medical abortion IUD insertion studies that reported IUD expulsion and IUD continuation rates. Results The search identified 17 clinical trials that were suitable based on the data they presented. The majority concerned T-shape IUDs, inserted immediately following surgical (aspiration) pregnancy termination. Two studies were conducted after medical TOP, and four studies were conducted with the frameless IUD inserted after surgical (vacuum aspiration) TOP. The results showed expulsion rates between 0.8% and 17.3% at 8 weeks, up to 5 years after insertion, respectively. In four studies with the frameless IUD, totaling 553 insertions, the expulsion rate was 0.0% in three of them. Follow-up in the latter studies varied between 5 weeks and 54 months. Reported continuation rates with conventional (framed) IUDs were between 33.8% and 80% at 1 year for studies providing 1 year rates and between 68% and 94.1% for studies reporting continuation rates at 6 months. Studies utilizing frameless IUDs reported 1 year continuation rate over 95%. Conclusion Frameless IUDs, due to their attachment to the uterine fundus, appear to be better retained by the postabortal uterus when compared with conventional framed IUDs. The absence of a frame ensures compatibility with uterine cavity anatomical dimensions, and may therefore result in improved acceptability and continuation rates in comparison with framed IUDs. Both these characteristics of the frameless IUD could help reduce the number of repeat unwanted pregnancies and subsequent abortions in some cases.
Intersectionality and reflexivity in medical education research

issues of ethnicity, race and culture. In line with the advice offered by Betancourt and Lopez for the field of psychology, we believe we should aim to advance understanding of the role of culture in medical education and to contribute to theory development and application in two ways: firstly, by enhancing experimentation and the use of theory in cross-cultural research (bottom-up), and, secondly, by infusing the study of culture in mainstream research (top-down).
Going Mobile: Delivering Behavioural Support via SMS Text Messages

Health organisations, charities, pharmaceutical companies, and health services are increasingly delivering information and support by SMS text message to help us change our health behaviours. For example, the British Heart Foundation provide a ‘Heart Health’ texting support service for people wanting to either become more active, eat healthier or give up smoking. So what do we know about the potential of text messaging to deliver behavioural support?
TCP Reaction to Rapid Changes of the Link Characteristics due to Handover in a Mobile Environment

The Transmission Control Protocol (TCP), used in the Internet, was not developed for a mobile, wireless environment. One reason why TCP might encounter problems in such an environment is rapid changes of the link characteristics. These rapid changes can occur due to handover between two subnetworks (macro handover), e.g., when a mobile node switches between different access networks. A possible and realistic handover scenario could be when a mobile node is roaming between a high bandwidth local area network (LAN) with limited coverage and a low bandwidth radio link with wide area coverage. The goals of this thesis were to set up a realistic environment for measurements of the handover performance of TCP, and to observe TCP behavior when the link characteristics suddenly change. Further objectives were to analyze the results and propose solutions for improving the performance. The mobility management in the measurement setup is handled by Mobile IP. Handovers are performed between a wireless LAN (WaveLAN) and a PPP link over a GSM circuit switched data connection. Our investigation shows that several spurious TCP timeouts occur after handover from the fast link to the slow link, triggering unnecessary retransmissions and hence resulting in TCP performance degradation. To avoid unnecessary retransmissions, we suggest a resetting of the retransmission timeout value (RTO) at the moment of handover. In the case of handover from the low bandwidth link (PPP) to the high bandwidth link (WaveLAN), our measurements show that queued packets in the link layer buffer continue to flow over the PPP link even after the handover. The high bandwidth available after the switch is thus poorly utilized before the buffer of the low bandwidth link has been emptied. The IP sending process should delay putting packets in the queue of a slow link, thus avoiding large link layer queues and enabling utilization of the high bandwidth link faster. This could be achieved by flow control between the IP layer and the link layer. After the packets have started flowing over the WaveLAN, the RTO value is unnecessarily high, which could result in extensive delays in the case of packet losses. To alleviate the problems we recommend resetting the RTO value or modifying the algorithm for calculating the RTO value to faster adapt to sudden and significant decrease of the round-trip time (RTT) in the case of handover. In both handover scenarios mentioned above we have found that a small window size is favorable to mitigate the negative effects due to the rapid changes of the link characteristics. The use of Active Queue Management to avoid large window sizes would be an interesting approach for future investigations. Another interesting approach could be to have flow control between the IP layer and the link layer to avoid a large link layer queue when the handover from [one link to another occurs. ]
Attempts to reach the oldest and frailest: recruitment, adherence, and retention of urban elderly persons to a falls reduction exercise program.

PURPOSE OF THE STUDY To assess the recruitment, adherence, and retention of urban elderly, predominantly African Americans to a falls reduction exercise program. DESIGN AND METHODS The randomized controlled trial was designed as an intervention development pilot study. The goal was to develop a culturally sensitive intervention for elderly persons who suffered a fall and visited an emergency department (ED). Participants were taught exercises during 4 on-site group classes and encouraged to continue exercising at home for 12 weeks and attend additional on-site monthly classes. The protocol included a specifically designed intervention for increasing retention through trained community interventionists drawn from the participants' neighborhoods. RESULTS The screening of 1,521 ED records after falling yielded the recruitment of 204 patients aged 65 years and older. Half were randomized into the falls prevention program. Of the 102 people in the intervention group, 92 completed the final 6-month assessment, 68 attended all on-site sessions, but only 1 reported exercising at home all 12 weeks. Those who lived alone were more likely (p = .03) and those with symptoms of depression were less likely (p = .05) to attend all on-site exercise classes. The final recruitment rate was estimated as 31.8%. The final retention rates were 90.2% and 87.3% for the intervention and control groups, respectively. IMPLICATIONS Recruitment of frail elderly African American patients is resource intensive. Adherence to the on-site exercise classes was better than to the home-based component of the program. These findings have implications for the design of future community-based exercise programs and trials.
Self-care strategies and barriers among kidney transplant recipients: a qualitative study

Objectives: We investigated kidney transplant recipients' self-reported levels of exercise and fluid intake. We also examined attitudes about, barriers to undertaking, and strategies used to initiate and maintain adequate self-care for fluid intake, exercise and dietary practices. Methods: A qualitative approach was used and supplemented by quantitative data to examine self-care among kidney transplant recipients (n = 82), including a semi-structured interview and survey of physical activity. Results: One-third of patients (33%) reported drinking the recommended 3 L of fluid each day. However, the majority (60%) reported not receiving this or any specific fluid intake recommendation. Twenty percent reported engaging in moderate to regular physical activity while 78% were sedentary. However, many reported that clinicians did not specify the amount of exercise (39%) or did not discuss exercise (15%). Attitudes towards fluid intake, exercise and maintaining a low-salt diet were mostly positive; patients expressed relatively more negative attitudes towards maintaining a low-cholesterol diet. Major barriers to fluid intake were not feeling thirsty, difficulty breaking the habit of limiting fluid intake formed while on dialysis, feeling full and limited access to fluids. Patients devised creative strategies to initiate and maintain appropriate hydration, physical activity and dietary levels, including intentionally drinking when not thirsty, modifying the environment, tracking intake and relying on social supports. Conclusions: Few kidney recipients practiced optimal self-care for fluid intake or physical activity. Most patients encountered barriers to self-care that should be ameliorated to assist patients with managing their transplant. Understanding barriers and strategies is essential for developing educational interventions.
Birth weight and asthma incidence by asthma phenotype pattern in a racially diverse cohort followed through adolescence

Abstract Objective: Low birth weight (LBW) has been shown to be an independent risk factor for asthma. We hypothesized that LBW would have its greatest impact on early onset disease. Methods: A racially diverse cohort of children born from 1983 to 1985 at two hospitals, one urban and one suburban in the same metropolitan area, and oversampled for babies weighing ≤2500 g, was identified retrospectively when the children were 6 years of age and followed periodically. At the age 17 years study visit, cohort members and their parent/guardians were separately interviewed face-to-face regarding the subject’s history of asthma using the standardized ISAAC questionnaire. We measured the cumulative incidence of asthma from birth through adolescence defined by age of diagnosis and persistence/remittance. Results: Six-hundred and eighty teens (82.6% of the original cohort) were included in the analyses, 387 with LBW and 293 of normal birth weight. The prevalence of physician-diagnosed “Current Asthma” was associated with LBW (p = 0.003 for trend), with patterns stronger in males and whites. LBW was associated most strongly with Late Onset Persistent asthma (current asthma that was diagnosed after 8 years); p for trend 0.032. This trend was again most evident in males and whites. None of the asthma categories classified as “remittent” were statistically associated with LBW. Conclusions: LBW was not associated with diagnosed asthma that remitted before age 17 years. LBW was associated with asthma diagnosis in mid-childhood that persisted through adolescence, suggesting that the asthmagenic effects of LBW can become evident post the early years of childhood and persist into adulthood.
Understanding cloud computing adoption: A model comparison approach

The purpose of this paper is to understand cloud computing adoption. Specifically, this paper aims to compare two theoretical models and an integrated model to identify which theoretical models best predicts cloud computing adoption. An empirical study was conducted through an survey from 280 companies in IT, manufacturing and finance sectors in India. The data was analysed using exploratory and confirmatory factor analyses. Further, structural equation modeling using AMOS 20.0 was used to test the proposed model. Results show that the integrated mediating TAM-TOE and Direct TAM- TOE model have greater explanatory power of cloud computing adoption intention than the technology acceptance model (TAM) and technological organisational environmental framework (TOE). Mediating TAM-TOE provides more complete understanding of adoption intention and Direct TAM-TOE provides the generic cognition of understanding adoption intention and determinants of managerial decision making. Thus, the Mediating TAM-TOE is a preferable model. Security concern and Third party control are salient factors influencing cloud computing adoption intention through perceived usefulness (PU) and perceived ease of use (PU). This study is one of the first studies to examine of influence change of variables and compare the relative ability of two competing theories, TAM and TOE, and an integrated model in explaining cloud computing adoption intention.
The raised midpoint potential of the [2Fe2S] cluster of cytochrome bc1 is mediated by both the Qo site occupants and the head domain position of the Fe-S protein subunit.

We have previously reported that mutant strains of Rhodobacter capsulatus that have alanine insertions (+nAla mutants) in the hinge region of the iron sulfur (Fe-S) containing subunit of the bc(1) complex have increased redox midpoint potentials (E(m)) for their [2Fe2S] clusters. The alteration of the E(m) in these strains, which contain mutations far from the metal binding site, implied that the local environment of the metal center is indirectly altered by a change in the interaction of this subunit with the hydroquinone oxidizing (Q(o)) site [Darrouzet, E. , Valkova-Valchanova, M. , and Daldal, F. (2002) J. Biol. Chem. 277, 3464-3470]. Subsequently, the E(m) changes have been proposed to be predominantly due to a stronger or more stabilized hydrogen bonding between the reduced [2Fe2S] cluster and the Q(o) site inhabitant ubiquinone (Q) [Shinkarev, V. P., Kolling, D. R. J., Miller, T. J., and Crofts, A. R. (2002) Biochemistry 41, 14372-14382]. To further investigate this issue, Fe-S protein-Q interactions were monitored by electron paramagnetic resonance (EPR) spectroscopy and the findings indicated that the wild type and mutant proteins interactions with Q are similar. Moreover, when the Q(pool) was chemically depleted, the E(m) of the [2Fe2S] cluster in mutant bc(1) complexes remained more positive than a similarly treated native enzyme (e.g., the [2Fe2S] E(m) of the +2Ala mutant was 55 mV more positive than the wild type). These data suggest that the increased E(m) of the [2Fe2S] cluster in the +nAla mutants is in part due to the cluster's interaction with Q, and in part to additional factors that are independent of hydrogen bonding to Q. One such factor, the possibility of a different position of the Fe-S at the Q(o) site of the mutant proteins versus the native enzyme, was addressed by determining the orientation of the [2Fe2S] cluster in the membrane using EPR spectroscopy. In the case of the +2Ala mutant, the [2Fe2S] cluster orientation in the absence of inhibitor is different than that seen in the native enzyme. However, the +2Ala mutant cluster shared a similar orientation with the native enzyme when both samples were exposed to either stigmatellin or myxothiazol. In addition, Q(pool) extracted membranes of +2Ala mutant exhibited fewer overall orientations, with the predominant one being more similar to that observed in the non-Q-depleted membranes of the +2Ala mutant than the Q-depleted membranes of a wild-type strain. Therefore, additional component(s) that are independent of Q(o) site inhabitants and that originate from the newly observed orientations of the [2Fe2S] clusters in the +nAla mutants also contribute to the increased midpoint potentials of their [2Fe2S] clusters. While the molecular basis of these components remains to be determined, salient implications of these findings in terms of Q(o) site catalysis are discussed.
Evaluation of the Cornea and Anterior Chamber Morphologic Changes After Penetrating Keratoplasty in Patients With Keratoconus

Objectives: To evaluate changes of the cornea and anterior chamber after penetrating keratoplasty in eyes with keratoconus. Methods: Medical records of 68 eyes of 68 patients with keratoconus who experienced penetrating keratoplasty at the Eye Clinic of Dr. Lütfi Kirdar Kartal Research and Training Hospital between 2010 and 2012 were studied. Records were retrospectively evaluated with regard to anterior chamber depth, iridocorneal angle, central corneal thickness, thinnest corneal thickness, maximum keratometric value, and mean keratometric value. Patients who developed complications and required additional surgery were excluded. Results: A total of 68 eyes of 68 patients were included in this study. There were 40 (58.8%) male and 28 (41.2%) female patients. The mean age was 24.5±8.19 years (range: 11–42 years). The graft diameter was 7.5 mm and the recipient bed diameter was 7.0 mm in all patients. The preoperative anterior chamber depth decreased from 3.92±0.47 mm to 3.01±0.55 mm (23% decrease). No significant postoperative change was observed in the mean iridocorneal angle values. Keratometric values decreased by 30% and corneal thickness increased by 50% (P<0.001 for both). Conclusion: Anterior chamber depth decreased significantly, but no change was observed in iridocorneal angle after penetrating keratoplasty in patients with keratoconus. Also, a decrease in the keratometric values and an increase in corneal thickness were observed. Understanding, estimating, and managing changes in the anterior chamber after penetrating keratoplasty, which induces significant changes in anterior chamber morphology, might increase the success of surgery.
Antibody to cytotoxin in infection by Helicobacter pylori

Gastrointestinal disease and colonization by Helicobacter pylori were determined in 36 asymptomatic volunteers and 30 symptomatic individuals undergoing endoscopy and biopsy. Serum antibody immunoglobulin G (IgG) and IgA to H. pylori were measured by enzyme-linked immunosorbent assay. Serum antibody to a cytotoxin produced by H. pylori was detected with a neutralization assay. Serum IgG was 95% predictive of infection by H. pylori, and serum IgA was 88% predictive. Antibody to the cytotoxin was detected in 12 of 18 infected individuals. Antibody to the cytotoxin was a highly specific (96%), but not a very sensitive (67%), indicator of infection by H. pylori. The neutralization assay was 87% predictive of infection. These data confirm the diagnostic value of serum antibody to H. pylori for the detection of infection. The toxin-neutralizing activity of sera from individuals infected with H. pylori suggests that the cytotoxin is produced in vivo. It may therefore contribute to disease associated with H. pylori.
An examination of executive perquisites and their relationship to strategic productivity

For well over 50 years, researchers have explored the relationship between executive compensation and company performance, often with mixed results. However, regardless of which valuation methodologies one uses, or the limitations one accepts, the reality is that executive compensation represents a significant expense for United States corporations. CEO’s and Executive Level Vice Presidents are engaged in almost pure strategic planning, industry analysis and environmental scanning. This study examined some actions companies can make to remove distractions, reduce delays and save the executive time to focus on their work. The authors explore the relative costs of various time saving programs and assistance, and explore the potential productivity benefits of such assistance.
Comparative study with enoxacin and netilmicin in a pharmacodynamic model to determine importance of ratio of antibiotic peak concentration to MIC for bactericidal activity and emergence of resistance

An in vitro pharmacokinetic model was used to study the comparative antibacterial activities of multiple-dose regimens of enoxacin and netilmicin. Strains of Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus were exposed to changing drug concentrations, mimicking human two-compartment pharmacokinetics. Oral administration was simulated for the quinolone, and intravenous administration was simulated for the aminoglycoside. Similar ratios of peak concentration to MIC resulted in similar changes in bacterial concentrations over time with both compounds. Following the initial dose, a rapid bactericidal effect occurred, with a greater than 99% reduction of the bacterial counts within 4 h at peak concentrations more than three times the MIC. However, bacterial regrowth occurred within 24 h unless the peak concentration/MIC ratio exceeded 8:1 (P less than 0.01). For the regrowing bacteria, MICs were four- to eightfold higher, and little or no bactericidal effect occurred following the second and subsequent doses. These data demonstrate the equally potent bactericidal activity of orally administered enoxacin and intravenously administered netilmicin. Selection of resistant subpopulations was similar with each drug. The peak concentration/MIC ratio may be an important parameter in the clinical use of quinolone and aminoglycoside antibiotics.
Getting What We Pay For: Low Overhead Limits Nonprofit Effectiveness

This brief is the first of two that summarize results from detailed case studies of the financial management of nine nonprofit organizations. It focuses on the relationship between spending on administration and fundraising and the effectiveness of nonprofit organizations in carrying out their missions. Smaller organizations tended to invest less in organizational infrastructure, resulting in conditions that compromised their effectiveness. Part of the reason why these organizations invested less in infrastructure involved their reliance on grants with limits on how much could be spent on overhead costs. The overhead cost project is a collaboration with the Center on Philanthropy at Indiana University.