Miracle-dz/UniFAR-FTUs huggingface dataset:
Vorsorgeuntersuchungen und Check-ups in der Kardiologie

Abstract Cardiovascular diseases (CVD), especially coronary artery disease (CAD), are the leading causes of morbidity and mortality worldwide. Elimination of modifiable risk factors has the potential to prevent up to 80 % of CVD. Therefore, disease prevention is based on the assessment of individual total CVD risk by using risk scores such as SCORE-algorithm that include the known main cardiovascular risk factors such as age, sex, smoking status, arterial hypertension und cholesterol.
A Psychiatric Perspective on Erectile Dysfunction

Erecti le impotence is a co m mon fa mily heal th problem, with exact incidence unknown , that adversely affects both men and their female partners. It is classified as "inhibited sexual ex citement" in DSM-III and is defined as th e inability to attain or maintain a penile erection until co mpletion of th e sexua l act. It had been sta ted fo rmerly, without supporting evidence, that 90% of erectile di sorders were "psychogenic. " Today, however , only about one-third are so clas sified (1). In Kins ey's (2) series, th e prevalence of impotence was less than 2% until the age of 40 years; it increa sed to 6-7% at age 55 and by age 70 years more than one-fourth of mal es reported long-term erecti le incompetency. It is not certain to what extent this increased prevalence of e rectile disorder concurrent with aging is indicative of mental co nd it ions, or covert medical co nd it ions or th e natural biological changes induced by aging. Impoten ce ordinarily is cla ssified as: 1) primary (life long), or secondary (acquired after satisfactory potency); 2) partial o r total ; 3) generalized or situational.
Pathway Analysis of Genes Identified through Post-GWAS to Underpin Prostate Cancer Aetiology

Understanding the functional role of risk regions identified by genome-wide association studies (GWAS) has made considerable recent progress and is referred to as the post-GWAS era. Annotation of functional variants to the genes, including cis or trans and understanding their biological pathway/gene network enrichments, is expected to give rich dividends by elucidating the mechanisms underlying prostate cancer. To this aim, we compiled and analysed currently available post-GWAS data that is validated through further studies in prostate cancer, to investigate molecular biological pathways enriched for assigned functional genes. In total, about 100 canonical pathways were significantly, at false discovery rate (FDR) < 0.05), enriched in assigned genes using different algorithms. The results have highlighted some well-known cancer signalling pathways, antigen presentation processes and enrichment in cell growth and development gene networks, suggesting risk loci may exert their functional effect on prostate cancer by acting through multiple gene sets and pathways. Additional upstream analysis of the involved genes identified critical transcription factors such as HDAC1 and STAT5A. We also investigated the common genes between post-GWAS and three well-annotated gene expression datasets to endeavour to uncover the main genes involved in prostate cancer development/progression. Post-GWAS generated knowledge of gene networks and pathways, although continuously evolving, if analysed further and targeted appropriately, will have an important impact on clinical management of the disease.
Anatomical localization of intracranial grade II meningiomas in North-Eastern Romania

Objective. Our research aims to assess a possible connection between tumour localization and histological subtypes of grade II meningiomas. Material and methods. 143 patients with grade II WHO meningiomas underwent surgical resection in "Prof. Dr. N. Oblu" Emergency Clinical Hospital Ia? i between 1990 and 2015. The collected data included: patient age, gender, tumour localization and histopathological diagnosis (atypical, clear cells and chordoid meningioma). Results. 135 (94.4%) of all 143 patients with grade II meningiomas were atypical meningiomas, 6 (4.2%) were cell clear meningiomas and only 2 (1.4%) were chordoid meningiomas. As concerns their distribution by gender, 79 (55.2%) were female and 64 (44.8%) were male. Grade II meningiomas were most commonly located at convexity 49.7% (n=71), followed by skull base in 30.8% (n=44) of the cases and parasagittal/falcine in 14.7% (n=21) of the patients. Conclusions. The most common localization of grade II meningiomas was convexity, followed by skull base, parasagittal/falcine and intraventricular areas. We have also noticed that convexity meningiomas are more frequent in women, unlike the other anatomical localizations in which the male-female ratio is almost equal. Therefore, further research is necessary to determine the role of embryological, anatomopathological and genetic factors in underlying the connection between meningioma grade and anatomical localization.
Inappropriate Testing for Clostridioides difficile in Long-Term Care: Implications Highlight the Need for an Algorithm

This article provides clear guidance related to appropriate testing for Clostridioides difficile (C. diff) and identifies the negative implications of inappropriate testing, repeat testing, and testing for cure. Residents of long-term care (LTC) facilities are at increased risk for developing C. diff. Complications can arise if a resident does not have an active C. diff infection (colonization) and has a positive C. diff laboratory test result. The authors share a fictional bedside story illustrating the negative consequences that can result from inappropriate C. diff testing, and present a decision tree that promotes mindful application of testing, which may result in cost savings and prevent adverse resident outcomes. Keywords: C. diff, long-term care, test, diarrhea, stool, algorithm, treatment, diagnosis
Adjusting for Time Varying Confounding in Adaptive Interdisciplinary Pain Management Program

ADJUSTING FOR TIME VARYING CONFOUNDING IN ADAPTIVE INTERDISCIPLINARY PAIN MANAGEMENT PROGRAM Nilabh Ohol The University of Texas at Arlington, 2017 Supervising Professor : Victoria C. P. Chen Interdisciplinary pain management combines multiple disciplines of professionals to understand the biological and psychosocial factors causing a patient's pain and to determine the best treatments among many to administer. The Eugene McDermott Center of Pain at University of Texas at Southwestern Medical Center in Dallas runs a two stage adaptive interdisciplinary pain management program with the aim to improve current and future pain outcomes. The sequential treatment regime for the pain and the observational nature of data yield to time varying confounding and a form of endogeneity. This yields biased estimates of the treatment effects which is undesirable. Our adaptive interdisciplinary pain management framework employs state transition and outcome models estimated from actual patient data in the program. This research develops a framework based on the inverse probability of treatment weighting technique to address endogeneity while estimating state transition and outcome models. The parameter estimates obtained from these models are unbiased and can be interpreted as causal effects of the treatments.
P-33 Characterising readiness for advance care planning (ACP): An interpretive descriptive study in supportive living

Background Supportive living (SL), also known as assisted-living, residents are at risk of progressive cognitive decline and physical frailty, requiring treatment decisions. As such ACP is recommended but the factors associated with readiness to engage in ACP in SL are not fully understood. Aim The purpose of this study was to explore perceptions of readiness, barriers and facilitators to ACP of SL residents, their families and clinicians. Method This qualitative study utilised an Interpretive Descriptive (ID) approach. Participants were 9 residents from 3 SL facilities, 6 family members and 8 SL clinicians in a health region with an ACP policy and procedure. Data collection consisted of semi-structured interviews with participants. Interviews were coded, analysed and themes developed within each group. Themes were also compared across the groups to understand areas of convergence and distinctness. Results For SL residents, ACP is closely related to making the transition to SL rather than health decisions. Clinicians are either task oriented or conflicted regarding ACP implementation. Families of SL residents draw on personal experience as most have lost a relative or experienced prior decision making for a family member. Early analysis demonstrates the emergence of five themes across the groups: conceptualization of ACP, readiness for engagement, health uncertainty and difficulty in decision-making, barriers/facilitators. Discussion These findings will be used in a knowledge-to-action program to inform the clinical approach, resources and health region processes aimed at increasing readiness for ACP and ACP engagement by patients and families in SL.
How to Make Bicycling Safer - Identification and Prevention of Serious Injuries among Bicyclists

Title: How to Make Bicycling Safer – Identification and Prevention of Serious Injuries among Bicyclists Author: Maria Ohlin Language: English with a Swedish summary ISBN: 978-91-7346-526-7 (print) ISBN: 978-91-7346-527-4 (pdf) ISSN: 0436-1121
The emerging role of mesenteric fat and its association with Crohn's disease

43 INTRODUCTION Crohn’s disease is a chronic inflammatory bowel disease, of uncertain etiology, characterized by transmural inflammation, with a predilection for the terminal ileum. In his original description of the disease, Burril Crohn described the characteristic mesenteric fat change (1). Although widely recognized, particularly by surgeons, the relevance of this fat hypertrophy and wrapping, referred to as “creeping fat,” is unknown, and has received little research attention. Accumulation of mesenteric fat, with fat wrapping, appears to be specific for Crohn’s disease, and occurs from the onset of disease (2). Fat wrapping has been defined as fat hypertrophy extending from the mesenteric attachment with >50% coverage of the intestinal surface (3). Fat wrapping occurs in both the small and large bowel, and correlates with transmural inflammation, ulceration, stricture formation, increased mesenteric wall thickness, and decreased internal bowel diameter (3). Fat wrapping and mural thickening is associated with mucosal ulceration in 86% of patients (4). In combination with serositis, it is associated with mucosal ulcers and cobblestones in 96% of patients and with strictures in 46% (4). Fat wrapping was noted in 100% of patients undergoing resection, and correlated with the degree of acute and chronic inflammation (5). The association of fat hypertrophy with Crohn’s disease raises the question of whether the fat wrapping is a consequence of transmural inflammation, probably caused by cytokine release from lymphoid tissue (3,4), or whether the fat is in some way responsible for the inflammatory changes. Cytokines such as transforming growth factor beta-1 (TGF-β1) and TNF-α stimulate proliferation and activation of mesenchymal tissues. Peroxisome proliferators-activated receptor γ (PPAR-γ) is expressed by the intestine and adipose tissue, and can modulate the activity of the inflammatory cytokines (6). It is a major regulator of adipocyte differentiation, and may therefore play a significant role in the development of mesenteric fat hypertrophy in Crohn’s disease.
Uterine Artery Doppler study and Serum B-Human Chorionic Gonadotropin as Predictors of Preeclampsia

Background: preeclampsia (PE) is defined as the presence of high blood pressure (BP > 140/90 mmHg) after 20 weeks gestation, in a previously normotensive non-proteinuric patient with one or more of the following: significant protienuria (> 0.3 g/24 h), maternal organ dysfunction or utero- placental dysfunction. Aim of the Work: screening of preeclampsia using serum β-HCG titre at 11-14 weeks of gestation and uterine artery Doppler study at 11-14 weeks and 22-24 weeks of gestation. Patients and Methods: the study was a prospective. It was conducted at the outpatient clinics of Obstetrics and Gynecology of Al-Zahraa University Hospital, Al-Azhar University during the period from February 2017 to April 2018. Results: the uterine artery pulsatility index (PI) and resistance index (RI) of both uterine artery were significantly high in those patients who developed PE. In the uterine artery Doppler study at 11-14 weeks of gestation, the mean PI and RI of both right and left uterine arteries were significantly different between the two groups, PI and RI were higher in PE group, the mean of right uterine artery PI in PE group was 2.39 ± 0.38 VS 1.69 ± 0.34 in non PE group. It was statistically highly significant (P value was 0.004). The maternal serum β-HCG titre was insignificantly different in those who developed preeclampsia and others. Conclusion: the maternal uterine artery PI and RI in early pregnancy (11-14 weeks of gestation) and in mid pregnancy (22-24 weeks of gestation) were increased and associated with occurrence of preeclampsia
Investigating Metastasis Using In Vitro Platforms

The complexity of the metastatic cascade has led to the development of a plethora of 2- and 3-dimensional in vitro assays to model the various steps of metastasis under a more controlled environment. These assays have been invaluable in cancer research not only as tools to delineate the molecular events that underpin metastasis but also to enable drug screens and validation of therapeutic targets. Here we review the advantages and limitations of current in vitro platforms used to investigate metastasis. In light of the overwhelming evidence showing that 3-dimentional culture systems better mimic the tumor microenvironment and therapeutic response in vivo, recent advances made toward the development of 3-dimensional culture systems and their applications are discussed in more detail. Relevant information on protocols and resources available to support scientists with an interest in metastasis research is also provided.
Screening for autonomic neuropathy using validated non-invasive scale among diabetes patients treated in the selected primary health centres of Puducherry, India: an operational research

Background: Diabetes autonomic neuropathy (DAN) is a complication of diabetes which has direct implications on the mortality of diabetes patients. American Diabetes Association (ADA-2017) guidelines recommend early recognition and treatment of DAN. In this regard, we conducted a study among diabetic patients treated in the selected PHCs of Puducherry to determine the proportion with DAN and to assess the factors associated with DAN.Methods: A cross-sectional analytical study was conducted among diabetics and information on socio-demographic details, morbidity and behavioural risk factors were elicited using semi-structured interview schedule. The COMPASS-31 questionnaire was administered to assess the autonomic neuropathy symptoms. The data was captured using EpiCollect mobile app and analysed using Stata 12.0 software. The proportion of DAN was expressed as percentage with 95% confidence interval. The association between independent factors and DAN was assessed using multivariate generalized linear models. The prevalence ratio with 95% CI was used to express the strength of association.Results: Of the total 303 individuals with diabetes, 32 {10.6% (95% CI: 7.3%-14.6%)} were screened positive for autonomic neuropathy using COMPASS-31 scale. The number of individuals with diabetes who needed to be screened (NNS) for finding one with autonomic neuropathy was 10 (303/32). Conclusions: One in ten individuals with diabetes was screened positive for autonomic neuropathy. With good yield, there is need for including autonomic neuropathy screening as a component in the comprehensive care provided to diabetes patients in the primary health centres.
Duchenne Muscular Dystrophy Newborn Screening: Evaluation of a New GSP® Neonatal Creatine Kinase-MM Kit in a US and Danish Population

Duchenne muscular dystrophy (DMD/Duchenne) is a progressive X-linked disease and is the most common pediatric-onset form of muscular dystrophy, affecting approximately 1:5000 live male births. DNA testing for mutations in the dystrophin gene confirms the diagnosis of this disorder. This study involves assessment of screening newborns for DMD using an immunoassay for muscle-type (MM) creatine kinase (CK) isoform—the GSP Neonatal CK-MM kit. Comparisons were made with CK activity determination by fluorescence measurement. In addition, the study evaluated the effect of gestational age, age of infant at time of sampling and how stable the CK-MM was over time. This assay discriminates well between normal, unaffected and Duchenne affected populations and is suitable for Duchenne newborn screening.
Pregnant women have inadequate fiber intake while consuming fiber‐rich diets in low‐income rural setting: Evidences from Analysis of common “ready‐to‐eat” stable foods

Abstract The intake of fiber‐rich foods during pregnancy has several health benefits to the pregnant woman including lowering the risks of diabetes, preeclampsia, and constipation. However, little is known about the content, daily intake levels, and adequacy of fiber among pregnant women in many low‐income settings. We aimed to identify common food items and determine adequacy of dietary fiber intake levels among pregnant women in rural Ethiopia. Dietary data were collected from a subsample (n = 55) of pregnant women enrolled to a larger prospective cohort study (n = 414). Dietary intake level was measured using repeated 24‐hr dietary recall method and weighing the total amount of daily food. Fiber content was determined using the Weende method supplemented by other sources.The mean [±SD] dietary fiber intake level was 25.89 [±5.09 mg/g] per day, which declined across pregnancy trimester from 26.01 [±9.18 mg/g] to 22.67 [±9.01 mg/g] and 24.56 [±9.98 mg/g] during the first, to second and third pregnancy trimesters, respectively. Boiled cereals and coffee contributed to nearly two‐thirds (63.2%) of the daily fiber intake, while the major bulk of daily food, enjera, contributed to less than a quarter (24.3%) of the fiber intake. Though dietary patterns favor diversified intake for fiber, the mean intake levels below the recommended levels and proportion of women getting adequate to the physiologic stages of pregnancy were inadequate compared to the standard. Mothers, in such community, could benefit from increasing overall intake of existing food to satisfy their fiber needs during pregnancy.
HOW WELL ARE ADOLESCENTS IN THE GOUDA DISTRICT OF WESTERN CAPE MEETING THE SOUTH AFRICAN FOOD-BASED DIETARY GUIDELINES FOR FAT, SUGAR AND SODIUM?

This study aimed to determine whether the dietary intake of primary school learners in a rural area of the Western Cape was in line with three of the South African food-based dietary guidelines: “Use fats sparingly, choose vegetable oils rather than hard fats”, “use sugar and foods and drinks high in sugar sparingly”, and “use salt and food high in salt sparingly”. A cross-sectional study was undertaken at two primary schools in low socioeconomic settings. Participants were grades five, six and seven learners (10-13 years old) at two schools in the Gouda District of the Western Cape (n=161). The learner’s sociodemographic status was determined by means of a questionnaire. Weight, height and mid-upper arm circumference were measured to assess the nutritional status of each learner. Dietary intake was measured by means of a 24-hour recall and an indicator food frequency questionnaire (FFQ). Results showed that 11.8% of learners were overweight and 5.6% were obese (17.4% BMI ≥ +1SD). Of the 161 participants, 30.4% of learners were above the recommended range of intakes for dietary fat intake, 54.7% of learners were above the recommended range for added sugar intake, and 51.6% of learners were above the recommended range for sodium intake. — Ms T Harris Nutrition Division Department of Human Biology University of Cape Town Cape Town South Africa Tel: +27 (0) 72 498 3434 Email: talyaharris95@gmail.com — Ms S Malczyk Nutrition Division Department of Human Biology University of Cape Town Cape Town South Africa Tel: +27 (0) 60 613 8397 Email: soniamalczyk@gmail.com — Ms N Jaffer Nutrition Division Department of Human Biology University of Cape Town Cape Town South Africa Tel: +27 (0) 082 566 6723 Email: nasreen@tiscali.co.za — Prof NP Steyn* Nutrition Division Department of Human Biology University of Cape Town Cape Town South Africa Tel: +27 (0) 21 65
Normalisation of salivary cortisol levels and self-report stress by a brief lunchtime visit to an art gallery by London City workers

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Endomyocardial diseases cardiomyopathy: A review and pooled analysis of pathophysiology, diagnosis and clinical management

Endomyocardial diseases are a rare and poorly understood aetiology of cardiomyopathy (CM). Common endomyocardial diseases capable of causing CM are endomyocardial fibrosis (EMF), hypereosinophilic syndrome (HES) with cardiac involvement and endocardial fibroelastosis (EFE). The key pathogenic mechanisms of HES and EMF are sustained eosinophilia while EFE is cardiac anomalies, infections or genetics causing fibroelastic thickening of the endocardium and systolic dysfunction. However, the recent classifications by the American Heart Association and the European Society of Cardiology describe CM due to endomyocardial diseases within the restrictive CM phenotype yet they might be two clinically distinct entities. Endomyocardial diseases as a cause of CM also lack sufficient evidence to develop a clear understanding of their natural course, diagnosis and management. Available evidence rely largely on earlier studies that have not incorporated progressive changes in non-invasive cardiac imaging that have occurred over the decades. Improved understanding of the disease and diagnosis is essential since early diagnosis and treatment targeted at the cause is essential to improve efficacy and survival. This paper therefore reviews published data on CMs due to endomyocardial diseases with a focus on epidemiology, aetiology, pathological features, clinical presentation, diagnosis and management. Improved knowledge on aetiologies of CMs such as endomyocardial diseases is important to develop targeted treatment and improve both patient and clinical outcomes. *Correspondence to: Aref Albakri, St-Marien hospital Bonn Venusberg, Department of internal medicine, Bonn, Germany, E-mail: arefalbakri@yahoo.com