Miracle-dz/UniFAR-FTUs huggingface dataset:
La economía del grupo doméstico: determinante de muerte materna entre mujeres indígenas de Chiapas, México

OBJETIVO: Evaluar la situacion economica y las relaciones de genero en cuanto factores determinantes de muerte materna en la subregion de Patwitz, en Chiapas, Mexico. METODOS: Se realizo un estudio cuantitativo y cualitativo mediante la aplicacion de una encuesta a 158 familias, entrevistas a profundidad a personas vinculadas con los casos de muerte materna y a lideres sociales de la region, asi como grupos focales con parteras. RESULTADOS: La toma de decisiones respecto a la salud de la mujer en el seno de la familia constituye un problema critico por cuanto depende exclusivamente del esposo y los familiares de este. Cuando el embarazo o el parto conllevan algun riesgo, tal situacion introduce restricciones en la eleccion de opciones de atencion fuera de la comunidad, de modo que 48,7% de los casos obstetricos son atendidos por parteras, 45,3% por familiares y 6% por la pareja. El problema se agrava por la alta marginacion y el muy bajo indice de desarrollo humano que caracterizan a la region estudiada, por la falta de acceso de las mujeres a la posesion de bienes, incluida la herencia de la tierra, y por el hecho de que 97,7% de ellas hablan solamente lenguas indigenas. CONCLUSIONES: Las inequidades por razones de genero en las familias indigenas, aunadas a una economia que no cubre las necesidades basicas, son factores que contribuyen a que las mujeres no reciban atencion en el proceso reproductivo. Debido al bajo nivel socioeconomico, las decisiones que se toman en torno a la atencion del embarazo, el parto y el puerperio tienen un alto costo en la salud y en la vida de las mujeres.
The use of routinely collected computer data for research in primary care: opportunities and challenges.

INTRODUCTION Routinely collected primary care data has underpinned research that has helped define primary care as a specialty. In the early years of the discipline, data were collected manually, but digital data collection now makes large volumes of data readily available. Primary care informatics is emerging as an academic discipline for the scientific study of how to harness these data. This paper reviews how data are stored in primary care computer systems; current use of large primary care research databases; and, the opportunities and challenges for using routinely collected primary care data in research. OPPORTUNITIES (1) Growing volumes of routinely recorded data. (2) Improving data quality. (3) Technological progress enabling large datasets to be processed. (4) The potential to link clinical data in family practice with other data including genetic databases. (5) An established body of know-how within the international health informatics community. CHALLENGES (1) Research methods for working with large primary care datasets are limited. (2) How to infer meaning from data. (3) Pace of change in medicine and technology. (4) Integrating systems where there is often no reliable unique identifier and between health (person-based records) and social care (care-based records-e.g. child protection). (5) Achieving appropriate levels of information security, confidentiality, and privacy. CONCLUSION Routinely collected primary care computer data, aggregated into large databases, is used for audit, quality improvement, health service planning, epidemiological study and research. However, gaps exist in the literature about how to find relevant data, select appropriate research methods and ensure that the correct inferences are drawn.
Valor pronóstico de la cistacina C como biomarcador en insuficiencia cardiaca crónica agudizada con función sistólica preservada y su relación con otros factores pronósticos clínicos

espanolEl objetivo del estudio es identificar si los niveles sericos de cistatina C al ingreso en pacientes con insuficiencia cardiaca y funcion sistolica preservada que son hospitalizados por empeoramiento clinico predicen peor pronostico. Determinamos cistatina C en un estudio prospectivo de pacientes (n=233) con FEVI>45%. Durante un seguimiento de seis meses, 90 pacientes (42,1%) alcanzo el evento primario (mortalidad o reingreso). El mejor punto de corte fue 1,35 mg/l obtenido de una curva ROC. La cistatina C > 1,35 mg/dl se asocio a un HR ajustado de 3,12 (CI95% 1.84-5.29, P EnglishThe aim of the work is to identify if serum levels of cystatin C on admission in patients with heart failure with preserved systolic function (HFPSF) who were hospitalized for worsening symptoms reveal a poor prognosis. We measured cystatin C in a prospective study of patients (n=233) with LVEF>45%. During a follow-up period of 6 months, 90 patients (42.1%) reached primary endpoint (mortality or readmission). The best cut-off level was 1.35 mg/L obtained by a ROC curve. Cystatin C>1.35 mg/L was associated with adjusted HR 3.12 (95% CI 1.84-5.29, P
An Intervention to Increase Caregiver Support for Asthma Management in Middle School-Aged Youth

Objective. Asthma control requires adherence to a treatment regimen. Caregiver involvement is a key determinant of adolescent asthma control, but the involvement must recognize the youth’s developmental stage and need for autonomy. This article describes the evaluation of a pilot asthma management intervention for middle school-aged youth and their adult network members, including caregivers, based on caregiver findings. Methods. Following approval from San Diego State University’s Institutional Review Board and school district authorization, two middle schools were randomized into one of two conditions: 6-weekly group-based skills training for the adolescents followed by 6-weekly targeted newsletters for caregivers and others (Group 1) versus group-based skills training for adolescents only (Group 2). Outcome evaluation examined pre–post changes by study condition. Results. Caregivers in both groups reported improvements in quality of life (QOL) and access to asthma care resources among their adolescents. Caregiver self-efficacy increased significantly among Group 1 versus Group 2 caregivers, while Group 2 caregivers (those who did not receive newsletters) reported that their adolescents had more responsibility for their asthma care compared with Group 2 caregivers. Conclusions. The adolescent-only intervention resulted in improvements in caregivers’ QOL and parenting behaviors that promoted the adolescent’s access to asthma resources. When caregivers were directed with intervention materials, their self-efficacy increased. Those who did not receive materials reported that their adolescents had more responsibility for their asthma care. The latter finding may reflect an unintended consequence of an adolescent-only intervention as it may communicate to caregivers to assume less responsibility for their child’s asthma care.
Treatment of peri-implantitis using a novel technique

Orodental rehabilitation through the use of implants offers very high success rates. Peri-implantitis is a site specific disease characterized by bone destruction around dental implants due to the host immune-inflammatory response induced by biofilm accumulation. Several approaches have been proposed to treat peri-implantitis, including mechanical debridement, antimicrobial therapy, and respective or regenerative surgical therapy. Calcium sulfate has multifaceted properties and has versatile use in the field of orthopedics. The present case report describes a peri-implantitis case treated by calcium sulphate which is a simple and easily available alloplastic material.
The Association of Overweight and Obesity with Spirometric Values in Minority Children Referred for Asthma Evaluation

Background. Overweight, obesity, and asthma are more prevalent in minority children; yet, the association of overweight and obesity with spirometric values in asthmatic minorities is not well characterized. Objective. To study the relationship between weight, ethnicity, and spirometric values in children referred for asthma evaluation to a large inner-city hospital in Bronx, NY. Methods. Retrospective review of spirometry done at the first pulmonary clinic visit of 980 asthmatic children, aged 7–20 years, was conducted. Linear regression analysis was performed to elucidate the association of overweight and obesity with pulmonary function among Whites, African Americans, and Hispanics compared with their normal weight counterparts. Results. More African Americans (58%) and Hispanics (65.4%) were overweight and obese than Whites (51.2%) (p < .05). Compared with their normal weight counterparts, percent forced expiratory volume in the 1st second (FEV1)/forced vital capacity (FVC) ratio was lower in both overweight and obese African Americans (2.99%, p < .05 and 3.56%, p < .01, respectively) and Hispanics (2.64%, p < .05 and 2.36%, p < .05, respectively); these differences were found in obese (3.73%, p < .05) but not in overweight (0.68%, p = .7) Whites. Conclusions. FEV1/FVC ratio was lower in both overweight and obese African American and Hispanic children, while this association was present only among obese Whites compared with their normal weight counterparts. These results suggest that spirometric measures of lower airway obstruction decrease with smaller weight increments in minority children when compared with White children. In the context of the higher prevalence of overweight and obesity among African Americans and Hispanics, our findings offer one potential explanation for increased asthma among minority children.
Spirometry and PRAM Severity Score Changes During Pediatric Acute Asthma Exacerbation Treatment in a Pediatric Emergency Department

Objectives. To examine the time-dependent changes of spirometry (percent-predicted forced expiratory volume in 1 second [%FEV1]) and the Pediatric Respiratory Assessment Measure (PRAM) during the treatment of acute asthma exacerbations. Study design. We conducted a prospective study of participants aged 5–17 years with acute asthma exacerbations managed in a Pediatric Emergency Department. %FEV1 and the PRAM were recorded pretreatment and at 2 and 4 hours. We examined responses at 2 and 4 hours following treatment and assessed whether the changes of %FEV1 and of the PRAM differed during the first and the second 2-hour treatment periods. Results. Among 503 participants, median [interquartile range, IQR] age was 8.8 [6.9, 11.4], 61% were male, and 63% were African-American. There was significant mean change of %FEV1 during the first (+15.4%; 95% CI 13.7 to 17.1; p < .0001), but not during the second (+1.5%; 95% CI −0.8 to 3.8; p = .21), 2-hour period and of the PRAM during the first (–2.1 points; 95% CI −2.3 to −1.9; p < .0001) and the second (–1.0 point; 95% CI −1.3 to −0.7; p < .0001) 2-hour periods. Conclusions. Most improvement of lung function and clinical severity occur in the first 2 hours of treatment. Among pediatric patients with acute asthma exacerbations, the PRAM detects significant and clinically meaningful change of severity during the second 2-hour treatment, whereas spirometry does not. This suggests that spirometry and clinical severity scores do not have similar trajectories and that clinical severity scores may be more sensitive to clinical change of acute asthma severity than spirometry.
Dynamics of bioenergetic microcompartments

Abstract The vast majority of life on earth is dependent on harvesting electrochemical potentials over membranes for the synthesis of ATP. Generation of membrane potential often relies on electron transport through membrane protein complexes, which vary among the bioenergetic membranes found in living organisms. In order to maximize the efficient harvesting of the electrochemical potential, energy loss must be minimized, and this is achieved partly by restricting certain events to specific microcompartments, on bioenergetic membranes. In this review we will describe the characteristics of the energy-converting supramolecular structures involved in oxidative phosphorylation in mitochondria and bacteria, and photophosphorylation. Efficient function of electron transfer pathways requires regulation of electron flow, and we will also discuss how this is partly achieved through dynamic re-compartmentation of the membrane complexes into different supercomplexes. In addition to supercomplexes, the supramolecular structure of the membrane, and in particular the role of water layers on the surface of the membrane in the prevention of wasteful proton escape (and therefore energy loss), is discussed in detail. In summary, the restriction of energetic processes to specific microcompartments on bioenergetic membranes minimizes energy loss, and dynamic rearrangement of these structures allows for regulation.
Epidemiology of keratoconus

Prevalence of keratoconus is variable in different parts of the world. Environmental and ethnic factors and the cohort of patients selected for such studies may explain the wide variation in the reported rates. Family history, gender differences, asymmetry in the two eyes, association with ocular rubbing, and natural history of disease are discussed.
Expression in non-melanogenic systems and purification of soluble variants of human tyrosinase

Abstract Mammalian tyrosinases are key enzymes of melanin formation. Their native forms undergo complex maturation and sorting processes before being integrated into the melanosomal membrane, which greatly complicates their heterologous expression in other cell types. In the present work, we constructed several differently truncated, soluble variants of human tyrosinase and studied their properties after expression in HEK 293 cells. In addition, we prepared two affinity-tagged forms of the enzyme for expression in the yeast Kluyveromyces lactis and HEK cells, respectively. A Strep-tagged variant was secreted by K. lactis in excellent yields but found to be inactive, whereas a His-tagged variant secreted by HEK 293 cells in an active state could be purified from cell supernatants to near homogeneity. The resulting preparation consisted of an inactive, probably unglycosylated species of about 57 kDa and several glycosylated forms with masses between 63 and 75 kDa, as confirmed by activity staining, Western blotting and mass spectrometry.
Morphision: A method for subjective evaluation of metamorphopsia in patients with unilateral macular pathology (i.e., full thickness macular hole and epiretinal membrane)

Background: Lack of clinical tests to quantify spatial components of distortion in patients with full thickness macular holes (FTMH) and epiretinal membranes (ERM). Aim: To develop a test for subjective evaluation of visual distortion in the central visual field around fixation in patients with unilateral FTMH or ERM. Settings and Design: Prospective case-control study carried out at tertiary referral center. Materials and Methods: Twenty-five patients with unilateral macular disease (13 macular epiretinal membranes, 12 full-thickness macular holes), and nine controls (without ocular pathology) underwent ophthalmological examination with logMAR ETDRS visual acuity, near vision and contrast sensitivity assessed. Macular optical coherence tomography and metamorphopsia assessment using Morphision test was also carried out. This test consists of a set of modified Amsler charts for detection, identification, and subjective quantification of visual distortion in the central visual field around fixation. Morphision test content and construct validity, and reliability (test-retest method) were evaluated. Sixteen patients completed an unstructured survey on test performance and preference. Results: Every patient with unilateral FTMH or ERM identified a particular chart using Morphision test (content validity). None of the normal subjects without symptoms of metamorphopsia identified any distortion (construct validity). Test-retest showed a 100% consistency for frequency and 67% for amplitude. The mean amplitude difference between measurements was 0.02 degrees (SD = 0.038). The coefficient of repeatability was 0.075. There was a correlation between Morphision amplitude score and visual acuity and contrast sensitivity, individually. Conclusions: Morphision test allowed detection and subjective quantification of metamorphopsia in the clinical setting in our patients with unilateral macular epiretinal membranes and full thickness macular holes.
Growth of Scytalidium sp. in a counterfeit bevacizumab bottle

After drawing a dose from an closed bevacizumab (Avastin) bottle, a fungus-like foreign body was observed inside. Samples from the vial were cultured in Sabouraud Emmons media. Growth of multiple light brown colonies with dark pigment was observed after 10 days. The species was identified as Scytalidium sp. Vial, analysis reported that the seal was lacking proper identification measures and that the label, batch number and expiry date did not correspond to a genuine product. Chemical analysis showed no protein, but 3% of polyethylene glycol, citrate and ethanol. Counterfeit bevacizumab is a real situation that poses a significant risk for ophthalmology and oncology patients. The medical community should be aware of this situation in order to enforce adequate preventive measures.
Systematic review of the effects of domestic paints on asthma related symptoms in people with or without asthma

Abstract Introduction: The association of respiratory problems with chemical emissions from common indoor materials has been studied but the specific effect of domestic paint has not been widely investigated. The aim of this review is to provide a comprehensive evaluation of experimental, occupational and epidemiological studies that examine the adverse respiratory effects of exposure to domestic paints. Methods: A literature search of PubMed together with consultation with an expert resulted in 997 articles published up to May 2011 of which 3 experimental, 4 occupational and 13 epidemiological studies met selection criteria and were included in the review. Results: The occupational literature suggested that work as a (non-spray) painter increases the risk of asthma, but it provides little insight to the risks of painting in the domestic setting. All epidemiological studies, except one, reported associations with some asthma-like symptoms. In children at least there was evidence that painting was associated with wheezing, but the study designs and the exposure assessment were unsuitable to differentiate between acute and longer terms affects. We found the epidemiological evidence to be weak and certainly insufficient to infer causality. Conclusion: The variable quality of the exposure assignment and heterogeneous study design makes it difficult to draw firm conclusions on whether domestic paint exposures cause or exacerbate asthma in children and/or adults.
Prevalence and severity of asthma and related symptoms in 6- to 7-year-old schoolchildren of Rio de Janeiro using of the ISAAC questionnaire by telephone survey

Abstract Objective: To evaluate the prevalence and severity of asthma and its association with sex in 6- to 7-year-old schoolchildren from the city of Rio de Janeiro (RJ), obtained by a telephone survey. Methods: A cross-sectional study using the International Study of Asthma and Allergies in Childhood (ISAAC) Written Questionnaire for Asthma adapted and validated by telephone interviews was conducted. The random sample was recruited systematically, without replacement, taking into account the proportion of school classes and students in each regional coordination of the Municipal Secretariat of Education, which supplied the students’ telephone numbers. The data were collected by a polling company from May to July 2010. Prevalence ratios (PRs) and 95% confidence intervals (95% CI) were compared using the difference in proportions test suitable for large samples to analyze the association between asthma and sex. Results: In total, 3216 interviews from parents/caregivers of children were analyzed; 51.4% of the children were males. Mothers were the primary respondents (71.9%). The prevalence rates of “wheezing ever” and “wheezing in the last 12 months” were 52.2% and 20.9%, respectively, and were significantly higher among boys (PR: 1.10, 95% CI: 1.03–1.18 and PR: 1.27, 95% CI: 1.10–1.45). The same pattern was observed for “asthma ever” (PR: 1.44, 95% CI: 1.12–1.85) and for “severe asthma” (PR: 1.42, 95% CI: 1.11–1.82). Conclusion: The prevalence of asthma was high among RJ’s students. Most of the indicators of the disease were more prevalent among boys. Our results were similar to those observed in other Brazilian and international centers using the traditional ISAAC protocol. The use of this method can be an alternative for epidemiological studies of childhood asthma especially in areas where the telephone coverage is high.
Site-directed spin labeling EPR spectroscopy in protein research

Abstract Site-directed spin labeling (SDSL) in combination with electron paramagnetic resonance (EPR) spectroscopy has emerged as an efficient tool to elucidate the structure and the conformational dynamics of proteins under conditions close to the native state. This review article summarizes the basics as well as the recent progress in SDSL and EPR methods, especially for investigations on protein structure, protein function, and interaction of proteins with other proteins or nucleic acids. Labeling techniques as well as EPR methods are introduced and exemplified with applications to systems that have been studied in the author’s laboratory in the past 15 years, headmost the sensory rhodopsin-transducer complex mediating the photophobic response of the halophilic archaeum Natronomonas pharaonis. Further examples underline the application of SDSL EPR spectroscopy to answer specific questions about the system under investigation, such as the nature and influence of interactions of proteins with other proteins or nucleic acids. Finally, it is discussed how SDSL EPR can be combined with other biophysical techniques to combine the strengths of the different methodologies.
Roles of elevated intravitreal IL-1β and IL-10 levels in proliferative diabetic retinopathy

Purpose: To determine the roles of interleukin (IL)-1β and IL-10 in the vitreous of proliferative diabetic retinopathy (PDR). Materials and Methods: Vitreous samples were obtained from 26 eyes of 26 patients with PDR and from eight eyes of eight cases without PDR. The IL-1β and IL-10 concentration in the vitreous was measured by using an enzyme-linked immunosorbent assay (ELISA). Results: Levels of IL-1β and IL-10 in vitreous were higher in PDR patients compared with control group. And there was significantly negative correlation between IL-1β and IL-10 in control group (r = −0.795; P = 0.032), whereas there was no significant correlation in PDR group (r = 0.176; P = 0.391). Conclusion: Levels of IL-1β and IL-10 were upregulated in vitreous of PDR patients, and these two cytokines play roles in regulating the development and progression of PDR.
Comparative Evaluation of Pan Anti-VEGF with Selective Anti-VEGF with Laser for Diabetic Macular Edema in Indian Eyes: A Randomized Prospective Study

Background: To evaluate intravitreal 0.5 mg ranibizumab plus laser with 0.3 mg pegaptanib plus laser with focal/ grid laser alone for treatment of diabetic macular edema (DME) Methods: A total of 45 study eyes with DME involving the fovea and visual acuity (VA) of 20/32 or worse were randomized into three groups, ranibizumab 0.5 mg + prompt laser (Group 1), pegaptanib sodium 0.3 mg + prompt laser (Group 2) and laser alone (Group 3) with 15 eyes in each study arm. Retreatment was based on optical coherence tomography measurements and VA changes. Results: The mean VA change (± standard deviation) at 1 year in Groups 1, 2 and 3 were 10.4±2.1, 7.6±2.3 and 2±2.7 letters (p<0.001) respectively on a standardized ETDRS chart. There was no significant difference between the VA gain between Group 1 and 2 at 1 year (p=0.189) however significant difference existed between Groups 1 and 2 when compared to Group 3 (p=0.0001). Conclusions: Ranibizumab and Pegaptanib with prompt focal/grid laser proved to be more effective than prompt focal/grid laser alone in treatment of center involved DME. There was no statistical difference in the visual gain achieved in the two intravitreal groups.