Miracle-dz/UniFAR-FTUs huggingface dataset:
Uterine scar rupture after a previous cesarean section and induction of labor with prostaglandins

In April 2003, a disciplinary court of the Dutch Medical Council ruled in a case of uterine rupture in a woman with a prior cesarean delivery, which took place in February 2001. The woman was gravida 2, para 1, whose first child was delivered by cesarean section because of breech presentation. In the present pregnancy she had prolonged rupture of membranes (PROM) at term. Priming with 1 mg of prostaglandin E2 gel (PGE2) was started 36 h after PROM. A second application of 2 mg was given six hours later. Three hours later contractions started and four hours after the onset of labor the woman suffered a uterine rupture, had an emergency cesarean section, and an asphyxiated child was born. The child died 10 days later. Several complaints were put forward by the mother, but perhaps the most intriguing issue is whether she should have been induced with PGE2 or not. In the court’s ruling of the case, a study from Washington State (USA), which indicates a higher incidence of uterine scar rupture after PGE2 induction, played a major role (1). Finally the court acquitted the obstetrician of liability during appeal in April 2004, taking into consideration that the US study and the accompanying editorial was published in July 2001 as the lead article in the renowned New England Journal of Medicine, five months after uterine rupture occurred (2). The verdict, however, suggested that if rupture had have happened after the publication, the Court’s ruling might have been different. Until the 1980s the rule ‘once a cesarean, always a cesarean’ was common practice, especially in the USA. Since then a trend has been seen towards vaginal birth after cesarean (VBAC), peaking in the mid 1990s, as one of the ways to curb the increasing cesarean section rate. The VBAC rate in the USA at that time was, however, never higher than 29%, while in Europe the rate was above 50%. Although the incidence of uterine scar rupture in VBAC is low (B/1%) and several large multicenter studies have confirmed the relative safety of VBAC, concern persists that uterine rupture may occur during a trial of labor (TOL) after a prior cesarean section (3 /6). VBAC is therefore still a controversial topic, which has been subjected to intense scrutiny. The quoted paper from the USA with related editorials and correspondence reignited this discussion. Several findings of this study are consistent with results of other studies. The incidence of uterine scar rupture in a TOL without induction (0.52%), and the slightly higher incidence when labor is induced without prostaglandins (0.77%) are in line with the results of other studies (5). However, the finding of a 2.45% risk of uterine rupture when PGE2 is used for * Present address: Atrium Medical Centre, Heerlen, The Netherlands.
Orthopaedic theatres: A popssible noise hazard?

IT IS known that noise in industry can damage hearing, but noise-induced hearing loss in operating theatre personnel has yet to be reported. This study was prompted by a casual meeting between an ENT surgeon and an Orthopaedic surgeon, when the latter complained of deafness in both ears without a past history of noise exposure or other ear disease, and recorded a pure tone audiogram typical of noise exposure (Fig. 1). The only likely source of noise was the high speed saws and drills currently in use in the Orthopaedic theatres. The noise level produced by these machines was measured, and pure tone audiograms obtained from the nursing staff and technicians working in these theatres. These were compared with a sample group without experience of work with similar noise.
COMPARISON OF ENVIRONMENTAL RADIATION MONITORING PROGRAMS IN CHINA AND THE UNITED STATES

The monitoring of environmental radiation has been carried out across the United States by the U.S. Environmental Protection Agency’s RadNet (formerly the Environmental Radiation Ambient Monitoring System, ERAMS) and the Global Network Program (GNP) of the Environmental Measurements Laboratory (EML), and in the People’s Republic of China (PRC) by their National Radioactivity Contamination Monitoring System (NRCMS). It is expected that an awareness of the similarities and differences in the structure and operation of these programs will prove helpful to both countries and perhaps others as they continue to develop their monitoring capabilities.
THE EFFECT OF MANUFACTURING VARIABLES ON RADIATION DOSES FROM PORCELAIN TILES

Previous studies have focused on the radiological properties of glazed ceramic tiles. This study was conducted to describe the radiological properties of porcelain tiles and how they were affected by variations in the manufacturing parameters. The data showed that the majority of the uranium in the tiles was attributable to the addition of zircon while less than half of the thorium in the tile was attributable to the added zircon, and the remainder came from other minerals in the formulation. The effects of firing temperatures and compressive strengths of the tiles are presented and show that higher firing temperatures increase radon emanation, while higher compressive strengths reduce radon emanation. The study also described how the addition of zircon to the tile formulation affected the radiological exposures that could be received by a member of the public from the use of such porcelain tiles. A dose assessment was conducted based on 23 different types of tile formulation. Screening procedures for building materials have been described in European Commission documents, and these limit the addition of zircon in a porcelain tile to ∼9% by mass. The dose assessment reported in this study showed that 20% zircon could be added to a porcelain tile without exceeding the prescribed dose limits.
The acceptability to patients and professionals of remote blood pressure monitoring using mobile phones

Aim To establish the acceptability of telemetric monitoring of blood pressure to patients and clinicians. Background Telemetric monitoring of blood pressure (BP) may allow clinicians and patients, in partnership, to more quickly control high BP through medication and lifestyle alterations. However, it is not clear if patients and clinicians would find such a system acceptable. Methods Questionnaire study followed by focus groups of patients with high BP, and clinicians involved in managing BP. Findings We received responses from 25 (50%) practice nurses, 76 (50%) general practitioners and 126 (62%) patients. We ran three focus groups of patients and clinicians. Participants were supportive of the technology, willing to try it, thought it would encourage adherence to medication and lifestyle and felt it would diagnose problems sooner than current methods. However, both groups thought the technology would be more useful for new patients or those whose BP was uncontrolled. They were concerned that individual high readings might provoke anxiety and thought patients would need reassurances about this. Clinicians were concerned about workload and the responsibility to act immediately when faced with a continuous stream of readings, regardless of how inconvenient this may be. Conclusion Participants, in general, welcomed this technology and thought it would aid adherence to medication and lifestyle advice, but felt it was most suitable to those with newly diagnosed or uncontrolled hypertension. Patients will need to be educated and reassured about the nature of occasional high readings and the need to consider average BP.
RADIOLOGICAL RISK ASSESSMENT OF CAPSTONE DEPLETED URANIUM AEROSOLS

Assessment of the health risk from exposure to aerosols of depleted uranium (DU) is an important outcome of the Capstone aerosol studies that established exposure ranges to personnel in armored combat vehicles perforated by DU munitions. Although the radiation exposure from DU is low, there is concern that DU deposited in the body may increase cancer rates. Radiation doses to various organs of the body resulting from the inhalation of DU aerosols measured in the Capstone studies were calculated using International Commission on Radiological Protection (ICRP) models. Organs and tissues with the highest calculated committed equivalent 50-y doses were lung and extrathoracic tissues (nose and nasal passages, pharynx, larynx, mouth, and thoracic lymph nodes). Doses to the bone surface and kidney were about 5 to 10% of the doses to the extrathoracic tissues. Organ-specific risks were estimated using ICRP and U.S. Environmental Protection Agency (EPA) methodologies. Risks for crewmembers and first responders were determined for selected scenarios based on the time interval of exposure and for vehicle and armor type. The lung was the organ with the highest cancer mortality risk, accounting for about 97% of the risks summed from all organs. The highest mean lifetime risk for lung cancer for the scenario with the longest exposure time interval (2 h) was 0.42%. This risk is low compared with the natural or background risk of 7.35%. These risks can be significantly reduced by using an existing ventilation system (if operable) and by reducing personnel time in the vehicle immediately after perforation.
CONE-BEAM IMAGING IN DENTISTRY

Cone-beam imaging has gained broad acceptance in dentistry in the last 5 years. The purpose of this review is to describe the use in dentistry and consider issues requiring further development. Cone-beam machines emit an x-ray beam shaped liked a cone rather than a fan as in conventional computed tomography (CT) machines. After this beam passes through the patient the remnant beam is captured on an amorphous silicon flat panel or image intensifier/charge-coupled device (CCD) detector. The beam diameter ranges from 4 to 30 cm and exposes the head in one pass around the patient capturing from 160 to 599 basis images. These images are used to compute a volume from which planar or curved reconstructions can be extracted in any orientation. Voxels are isotropic and can be as small as 0.125 mm. 3-D images of bone or soft tissue surfaces can also be generated. In dentistry the most common indications for cone-beam imaging are assessment of the jaws for placement of dental implants, evaluation of the temporomandibular joints for osseous degenerative changes, examination of teeth and facial structures for orthodontic treatment planning, evaluation of the proximity of lower wisdom teeth to the mandibular nerve prior to extraction, and evaluation of teeth and bone for signs of infections, cysts, or tumors. Cone-beam images have largely replaced conventional tomography for these tasks. The effective dose from cone-beam imaging ranges from 6 to 477 microSv. The cost of the equipment is relatively low, about $150,000 to $300,000. Issues to be considered are the training of individuals making and interpreting cone-beam images, as well as means to further reduce patient exposure.
Evidence for impaired physiological decrease in the uteroplacental vascular resistance in pregnant women with familial hypercholesterolemia

Abnormal hyperlipidemia characterizes pregnancy in familial hypercholesterolemia (FH), and is associated with vascular dysfunction. Hence, we compared blood flow in the feto‐ and uteroplacental circulation in FH and healthy reference women using Doppler velocimetry. The umbilical artery pulsatility index (PI) at gestational weeks 24 and 36, and the concomitant physiological decrease in PI, was similar in FH (n = 10) and the reference group (n = 143). The decrease in mean PI of both uterine arteries from week 24 to 36 was significant in the reference group, but not among the FH women. Plasma LDL‐cholesterol measured between weeks 24 and 36 was not correlated with the decrease in umbilical PI in the FH group, or with the decrease in umbilical or mean uterine PI in the reference group. We conclude that pregnancy in FH might be associated with attenuated physiological decrease in mean PI of uterine arteries, possibly reflecting increased uteroplacental vascular resistance unrelated to plasma LDL‐cholesterol levels.
County Mortality and Cancer Incidence in Relation to Living near Two Former Nuclear Materials Processing Facilities in Pennsylvania—An Update

A previous county mortality study of populations living near two nuclear materials processing and fabrication facilities in Westmoreland and Armstrong counties in Pennsylvania (1950–1995) was extended through 2004. Noncancer mortality (1996–2004) and cancer incidence (1990–2004) were also evaluated. Among the Westmoreland and Armstrong populations, 10,547 cancer deaths occurred during the period 1996 through 2004 and the relative risk (RR) based on comparisons with six demographically similar counties in western Pennsylvania was 0.97, that is, almost exactly as expected, and no different from our previously published analyses covering the years 1950–1995. The results based on cancer incidence data were very similar to those based on cancer mortality data. Over the years 1990 though 2004, 39,350 incident cancers were reported among residents of Armstrong and Westmoreland counties and the RR based on the six demographically similar counties was 0.99, that is, almost exactly as expected. The number of deaths from nonmalignant conditions was 36,565 and very close to the number expected (RR 1.01). Overall, no increases in cancer or nonmalignant diseases could be attributed to living in counties with nuclear materials processing and fabrication facilities.
Synergistic Cocatalytic Effect of Carbon Nanodots and Co3 O4 Nanoclusters for the Photoelectrochemical Water Oxidation on Hematite.

Cocatalysis plays an important role in enhancing the activity of semiconductor photocatalysts for solar water splitting. Compared to a single cocatalyst configuration, a cocatalytic system consisting of multiple components with different functions may realize outstanding enhancement through their interactions, yet limited research has been reported. Herein we describe the synergistic cocatalytic effect between carbon nanodots (CDots) and Co3 O4 , which promotes the photoelectrochemical water oxidation activity of the Fe2 O3 photoanode with a 60 mV cathodically shifted onset potential. The C/Co3 O4 -Fe2 O3 photoanode exhibits a photocurrent density of 1.48 mA cm(-2) at 1.23 V (vs. reversible hydrogen electrode), 78 % higher than that of the bare Fe2 O3 photoanode. The slow reaction process on the single Co(III) -OH site of the Co3 O4 cocatalyst, oxidizing H2 O to H2 O2 with two photogenerated holes, could be accelerated by the timely H2 O2 oxidation to O2 catalyzed on CDots.
Limited knowledge on progestogen‐only contraception and risk of venous thromboembolism

Objective. To assess the current knowledge concerning progestogen‐only contraception (POC) and risks of venous thromboembolism (VTE). Design and setting. Systematic review of the literature on observational and analytical studies reporting risk estimates for VTE in women exposed to POCs. Methods and main outcome measures. We performed a computerized literature search in the Pub Med, Embase, and the Cochrane Library for studies published between 1966 and February 13, 2008. Based on the evaluated studies we calculated an overall risk estimate for VTE in association with POC. Results. Four case‐control studies and one cohort study were included. Of the case‐control studies, three reported an increased risk and one a decreased risk of VTE. The cohort study found divergent results depending on the type of statistical analysis used. None of the results was statistically significant. The overall odds ratio for POC‐associated VTE in the four case‐control studies was 1.45 (95% CI = 0.92–2.26). Conclusions. The risk of VTE associated with use of POCs is poorly investigated. The slightly elevated overall risk estimate might suggest an association between POC and an increased risk for VTE. The results must, however, be interpreted with caution due to the possibility of residual confounding. Well‐designed studies with sufficient statistical power to evaluate risks of VTE with POC are warranted.
Repair of a Dimeric Azetidine Related to the Thymine-Cytosine (6-4) Photoproduct by Electron Transfer Photoreduction.

Photolyases are intriguing enzymes that take advantage of sunlight to restore lesions like cyclobutane pyrimidine dimers or (6-4) photoproducts. This work focused on the photoreductive process responsible for splitting of the azetidine ring proposed to occur during (6-4) photoproduct repair at a thymine-cytosine sequence. A model compound formed by photocycloaddition between thymine and 6-azauracil has been designed to mimic the elusive azetidine intermediate. The photoinduced electron transfer process has been investigated by means of steady-state and time-resolved fluorescence using photosensitizers with oxidation potentials in the singlet excited state ranging from -3.3 to -2.1 V vs. SCE. Azetidine ring splitting and recovery of "repaired" bases were proven by HPLC analysis.
Further observations on the disturbance of metabolism caused by injury, with particular reference to the dietary requirements of fracture cases

THE present writer has drawn attention to the marked loss of body nitrogen, sulphur, and phosphorus which occurs in the urine of otherwise healthy individuals who are in receipt of moderate or serious traumatic injury (Cuthbertson, 1930, 1931, 1932, 1934). This loss was observed to begin within a day or two following the injury, to reach a maximum within ten days
Critical pathway for cardiac rehabilitation after percutaneous coronary intervention.

Ranjan Dahiya, MD,* James Nance, KT,¶ Dan Johnson, PT,¶ Jon Wilke, PT,¶ Kent Wilson, PhD,¶ Robert Hall, PhD, Florinda Romero-Vagedes, RD,‡ Christine Wilson, RD,‡ William Jones, MS,§ Deborah Dye, PharmD,§ Julie Dzurick, PharmD,§ Janet Ohm, RN, MSN,* Paula Ericson, NP,* Christopher Wendel, MS, Jane Mohler, MPH, PhD, Prabhdeep S. Sethi, MD, MPH,* Hoang Thai, MD,* Steven Goldman, MD,* Edward Dick, MD,* Birger Rhenman, MD,† and Douglass A. Morrison, MD*
Importance of Micropore-Mesopore Interfaces in Carbon Dioxide Capture by Carbon-Based Materials.

Mesoporous carbonaceous materials (Starbons®) derived from low-value/waste bio-resources separate CO2 from CO2 /N2 mixtures. Compared to Norit activated charcoal (AC), Starbons® have much lower microporosities (8-32 % versus 73 %) yet adsorb up to 65 % more CO2 . The presence of interconnected micropores and mesopores is responsible for the enhanced CO2 adsorption. The Starbons® also showed three-four times higher selectivity for CO2 adsorption rather than N2 adsorption compared to AC.
Polypoidal choroidal vasculopathy associated with tilted disk syndrome.

PURPOSE To describe a complication of tilted disk syndrome-macular serous retinal detachment caused by development of polypoidal choroidal vasculopathy. METHODS A 65-year-old patient with visual loss and metamorphopsia was evaluated with fluorescein and indocyanine green angiography (ICG) and optical coherence tomography. Subsequently, photodynamic therapy (PDT) with verteporfin was administered. RESULTS Fundus examination showed classic features of tilted disk syndrome as well as a unilateral macular serous detachment secondary to a polypoidal lesion, which was clearly outlined by ICG angiography at the site of a macular lacquer crack. The lesion resolved after PDT. Two years after treatment, no recurrence was observed, and visual acuity was 20/25 without distortion. CONCLUSIONS In this patient with tilted disk syndrome, unilateral polypoidal choroidal vasculopathy was diagnosed by ICG angiography and treated successfully with PDT.
Extraskeletal myxoid chondrosarcoma of the orbit

Extraskeletal myxoid chondrosarcorna is a rare tumor that usually occurs in the soft tissues of the extremities and for which until now orbital involvement has never been reported. This report deals with an extraskeletal myxoid chondrosarcoma of the orbit in a 14-year-old boy. The prognosis and differential diagnosis are discussed.
Rates of Ear Disease in Children Visiting a Mobile Community Ear Clinic in New Zealand—Two-Year Study of Over 2,000 Children

Abstract Aims: To describe rates of middle ear disease in children attending a nurse-led mobile community ear clinic over a 2-year period in Wellington, New Zealand. Methods: Analysis of records of ear examination carried out over a 2-year period to identify rates of middle ear disease in children aged 0 to 18 years. All data were collected at the time of consultation. Otitis media with effusion (OME) being a common middle ear disease in children was investigated in more detail. Results: 2,273 children were seen in the ear clinic between July 2004 and June 2006. Nearly one in three children (28%) was diagnosed as having OME at their first ear clinic visit. Males of Pacific Island ethnicity, aged between 0 to 4 years had the highest rates (48.3%) of OME. Conclusions: Chronic middle ear disease continues to be a significant problem for children in New Zealand, particularly in the Hutt Valley (Wellington) region. This study showed that the childhood rate of ear disease continues to be unacceptably high. Chronic middle ear disease is a serious health risk for children, and could reach epidemic proportions if more resources are not allocated to the management of this disease in New Zealand. Repeated episodes of otitis media can result in hearing loss, language delay, difficulties in literacy, lowered school achievement, and other areas of learning at school. Effective prevention, detection, and intervention continue to be a significant public health challenge for this ever increasing disease, especially in children of Pacific Island origin. It is important that all children are seen as early as possible to ensure timely and appropriate care to minimize the impact of impaired hearing on early childhood development. Greater public health resources are required to minimize the impact of this disease, especially in Pacific Island children.
Influenza Vaccination Given at Least 2 Weeks Before Delivery to Pregnant Women Facilitates Transmission of Seroprotective Influenza-specific Antibodies to the Newborn

Background: Pregnant women and infants are at higher risk of complications secondary to influenza infection. Immunization during pregnancy facilitates protection of the neonates through passive transfer of maternal antibodies. Methods: This was a cross-sectional study performed during the post-H1N1 pandemic winter season of 2010/2011 in Geneva, Switzerland. We measured antibody titers against the seasonal influenza A H1N1, H3N2 and B 2010/2011 strains by hemagglutination inhibition in the umbilical cord blood of newborns born to vaccinated and nonvaccinated mothers. Seroprotection was defined as a hemagglutination inhibition titer ≥40. Results: A total of 188 women were enrolled, 101 of whom had been vaccinated with a nonadjuvanted influenza vaccine (all during the second or third trimester) and the other 87 had not. Among newborns of vaccinated women, 84–86% showed seroprotective levels depending on the strain. In comparison, seroprotection rates were significantly lower in babies of nonvaccinated women (29–33%, P < 0.001). Adjusting for various confounding factors and applying multivariate regression analysis, vaccination during pregnancy ≥2 weeks before delivery increased geometric mean titers in umbilical cord blood 5–17 times and seroprotection rates 5.8–34.4 times, depending on the strain and the interval between vaccination and delivery. Vaccinating pregnant women only 2–4 weeks before delivery was still more effective than no vaccination at all (geometric mean titers increased 6.8–11.1 times and seroprotection rates increased 5.8–34.4 times compared with nonvaccinated women). Conclusions: Influenza vaccination at any time during the second and third trimester of pregnancy, but at least 15 days before delivery, confers seroprotection to many neonates.