Miracle-dz/UniFAR-FTUs huggingface dataset:
Tesamorelin, a human growth hormone releasing factor analogue

Background: The combination of clinical effectiveness with a variety of adverse side effects from the use of recombinant human growth hormone (rhGH) in therapy for growth hormone (GH)-deficient disorders has led to the development of human growth hormone releasing factor (GFR) analogues, which may be better tolerated. Tesamorelin, a synthetic GFR, has been developed as a potential treatment for a variety of conditions that may be associated with a relative deficiency of GH including HIV-related lipodystrophy. Objective: This article reviews the development of tesamorelin and its purported role in HIV-related lipodystrophy and other potential indications. Methods: Relevant articles and abstracts were obtained from searches of the medical and chemical literature databases and the references from published articles. Results/conclusion: A multicenter, randomized, placebo-controlled, Phase III clinical trial suggested that tesamorelin might be a beneficial treatment strategy for HIV-related lipodystrophy with a good safety profile and a positive effect on reducing visceral fat. Other potential indications for tesamorelin appear less promising from the current data.
Long-term prophylactic treatment of attacks of vertigo in Menière's disease – comparison of a high with a low dosage of betahistine in an open trial

Conclusion. Despite the considerable limitations of an open, non-masked trial, particularly in Menière's disease (MD), a higher dosage of betahistine-dihydrochloride and a long-term treatment seems to be more effective than a low dosage and short-term treatment. Objective. To evaluate the prophylactic effects of a low versus high dosage long-term treatment with betahistine-dihydrochloride on the number of attacks in MD. Patients and methods. We performed an open, non-masked trial, in which patients with MD received either a low dosage of betahistine-dihydrochloride (16 or 24 mg tid) or a higher dosage of 48 mg tid for at least 12 months. The outcome measure was the number of attacks per month during a 3-month period. Non-parametric tests and a random effects model were used for statistical analysis. Results. A total of 112 patients were included in the analysis: 50 received betahistine-dihydrochloride in a low dosage (16 mg tid, n=21, 24 mg, n=29) and 62 received 48 mg tid. Follow-up examination every 3 months showed that the number of attacks per month decreased in both groups over time. For instance, after 12 months the mean (median) number of attacks dropped from 7.6 (4.5) to 4.4 (2.0) (p<0.0001) in the low-dosage group, and from 8.8 (5.5) to 1.0 (0.0) (p<0.0001) in the high dosage group. The number of attacks after 12 months was significantly lower in the high dosage group than in the low dosage group (p12M=0.0002). The treatment was well tolerated in both groups.
Racial and ethnic differences in physician assistant salaries

ABSTRACTTwo recent reports using different data sets concluded that female physician assistants (PAs) earn substantially less than male PAs. Similar data comparing the effect of race and ethnicity on salary have not been compiled. This article examines the possibility of racial and ethnic salary disparities in PA salaries using data from the 2009 survey of members of the American Academy of Physician Assistants.
Recipients Perception of Blood Transfusion Risk in Some Selected Tertiary Care Hospitals

This was a descriptive study carried out in the Medicine, Surgery, Gynae and Orthopedics ward of three randomly selected tertiary care hospitals at Dhaka, Bogra and Rangpur. It was aimed to evaluate the extent of understanding about the risk of blood transfusion among the blood recipients, to identify the common indications for blood transfusion through record review, to determine the recipients knowledge about indications of blood transfusion, their level of understanding about blood group, blood donors, and risk of blood transfusion and to find out the socio-demographic condition of recipients admitted at tertiary care hospitals. It was found that most of the respondents 63.17% were in the age group of 15-39 years and 56.95% were between primary to secondary level of education. More than half 56.83% respondents were housewife. The idea about indications of blood transfusion was found among 60.37% respondents. The idea about own blood group was found among 73.54% respondents. However, 52.93% respondents were unaware about the persons who can donate blood. Professional blood donor were the choice for own to only 15.60% respondents. The study also identified 57.32% respondents having risk of blood transmissible diseases. The respondents idea about transmissible diseases were identified as AIDs, Hepatitis-B, Syphilis and Malaria by 90.48%, 42.38%, 5.25% and 5.25% respectively. The study demands awareness and motivational program among younger and adult females in regards to transfusion transmissible diseases and its prevention. The importance of knowing blood group,donor selection and adverse effects of transfusion may also considered as a part of awareness program. It also demands a large scale community based survey to generate information towards development of effective strategy in minimizing risk of transfusion transmissible diseases in particular. DOI: http://dx.doi. org/10.3329/akmmcj.v5i2. 21129 Anwer Khan Modern Medical College Journal Vol. 5, No. 2: July 2014, Pages 30-33
Pediatric lead exposure and the water crisis in Flint, Michigan.

Changing the source of the water supply to save money had the unintended consequence of exposing residents of Flint, Mich. , to elevated lead levels in their drinking water. A study done at Flint's Hurley Children's Hospital demonstrated that the incidence of elevated blood lead levels of children living in the affected area nearly doubled after the change in the water source. This article reviews the recommendations for lead screening and for reporting, following, and treating children with blood lead levels greater than 5 mcg/dL.
Robot-assisted endoscope guidance versus manual endoscope guidance in functional endonasal sinus surgery (FESS)

Abstract Background: Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. Methods: We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance. In combination with the DICOM CT data, we tracked the endoscope poses and workspaces using self-developed tracking markers. Results: All surgeries were performed once with the robot and once with the surgeon holding the endoscope. Looking at the durations required, we observed a decrease in the operating time because one surgeon doing all the procedures and so a learning curve occurred what we expected. The visual inspection of the specimens showed no damages to any of the structures outside the paranasal sinuses. Conclusion: Robot-assisted endoscope guidance in sinus surgery is possible. Further CT data, however, are desirable for the surgical analysis of a tracker-based navigation within the anatomic borders. Our marker-based tracking of the endoscope as well as the instruments makes an automated endoscope guidance feasible. On the subjective side, we see that RASS brings a relief for the surgeon.
Biomarkers in Acute Cardiovascular Disease

Cardiovascular disease today remains a formidable foe affecting 1 in 3 Americans. The emergence of cardiac biochemical markers has provided clinicians unique insight into the state of the myocardium. In fact, cardiac biomarkers now represent an essential criterion in the definition of acute myocardial infarction. There has been impressive development of efficient and reliable assays to detect biomarkers in the serum. Together with patient history and electrocardiographic analysis, the invaluable information gained from serum cardiac biomarkers supports diagnosis, therapy selection, and determination of prognosis. Biomarkers such as troponin and creatine kinase MB have received well-deserved attention for their ability to detect myocardial ischemia. Clinicians today use cardiac markers to identify ischemia as well as alternate clinical states. B-type natriuretic peptide, for instance, reflects myocardial stretch as seen in heart failure exacerbations and may well have promising prognostic significance. The purpose of this review is to discuss current and emerging cardiac biomarkers in acutely ill patients. The advantages and disadvantages of biomarkers will also be presented in the context of their clinical uses. Present markers are highly sensitive and specific to myocardial injury; however they do not specifically identify the method of injury. An exciting potential exists for future biomarkers to demonstrate enhanced specificity and earlier detection of compromised myocardium.
Unmet Needs Following Hospitalization With Heart Failure: Implications for Clinical Assessment and Program Planning

Background: Measuring health status is increasingly important in both clinical practice and research. The Heart Failure Needs Assessment Questionnaire (HFNAQ) is a self-administered, disease-specific, 30-item questionnaire that measures an individual's perception of his/her needs in the physical, psychological, social, and spiritual domains. Objectives: To assess the prevalence of needs in patients with heart failure (HF) recently discharged from hospital. Methods: The HFNAQ was administered to participants (n = 132; mean [SD] age, 72.3 [9.69] years; 63% male) consenting to attend an HF-specific cardiac rehabilitation program. Results: The total mean HFNAQ score was 67.3 (95% confidence interval, 65.03-69.75), indicating an average level of need around the midrange of the scale. In this vulnerable postdischarge phase, there was evidence of predominance of psychological and social concerns over physical needs. None of the variables that were examined for associations with the measures of needs reached statistical significance, highlighting the strongly individualized perception of need. Conclusions: Higher levels of unmet needs in the psychological and social domains, compared with physical needs, identify psychosocial care as an important consideration for nursing interventions for people with HF. This study further demonstrates the importance of assessing the needs from the perspective of the individual to ascertain each person's unique perspective of the HF illness experience. Study findings further underscore the importance of individualized care planning for patients with HF after discharge from hospital to address their unique needs and circumstances.
Identification of Occupational Cancer Risks In British Columbia: A Population-Based Case–Control Study of 1129 Cases of Bladder Cancer

Objective: We collected information on lifetime occupational histories, smoking, and alcohol consumption from 15,463 incident cancer cases. Occupational risk factors for bladder cancer are presented in this report. Method: A matched case–control design was used. All cases were diagnosed with bladder cancers, with controls being internal controls consisting of all other cancer sites, excluding lung and unknown primary. Data were analyzed using conditional logistic regression for matched sets data and the likelihood ratio test. Results: Excess bladder cancer risks was observed in a number of occupation and industries, particularly those involving exposure to metals, including aluminum, paint and solvents, polycyclic aromatic hydrocarbons, diesel engine emissions, and textiles. Conclusions: The results of our study are in line with those from the literature and further suggest that exposure to silica and to electromagnetic fields may carry an increased risk of bladder cancer.
Nursing : the philosophy and science of caring

In the evolution of the nursing profession, the phrases nursing care, therapeutic care, caring for others, and related expressions are used by nurses to describe their professional service to others. Members of our society have different thoughts and role expectations about these phrases in relation to the kind of care they receive from nurses. Furthermore, these expressions hold different meanings for nurses in their various care-giving roles, such as to individual clients, families, and community groups they serve. The concept of care is probably one of the least understood ideas used by professional and non-professional people, yet it is probably one of the most important concepts to be understood by human groups. It is a word with multiple social usages in the American culture, and has other meanings in other world cultures. It is time that we study the implicit and explicit meanings associated with the concepts of care and caring so that we can reduce their ambiguities.
Novel Imprinted Polymer for the Preconcentration of Cadmium with Determination by Inductively Coupled Plasma Mass Spectrometry

ABSTRACT A novel Cd(II)-imprinted polymer was prepared with chemical immobilization using N-methacryloyl-L-Histidine as a vinylated chelating agent for online solid-phase extraction of Cd(II) for determination by inductively coupled plasma mass spectrometry. The Cd(II)–monomer complex was synthesized and copolymerized through bulk polymerization method in the presence of ethyleneglycoldimethacrylate cross-linker. The resulting polymer was leached with 1.0 mol L−1 HNO3 to generate the cavities in the polymer for Cd(II) ions. The experimental conditions, including load pH, solution flow rate, and eluent concentration for effective sorption of Cd(II), were optimized using a minicolumn of the imprinted polymer. A volume of 5.0 mL sample 5 µg L−1 Cd(II) solution at pH 6.5 was loaded on the column at 2.0 mL min−1 using a sequential injection system followed by elution with 1.0 mL of 0.75 mol L−1 HNO3. The relative selectivity coefficients of the imprinted polymer for Cd(II) were 38.5, 3.5, 3.0, 2.5, and 6.0 in the presence of Cu(II), Ni(II), Zn(II), Co(II), and Pb(II), respectively. Computational calculations revealed that the selectivity of the imprinted polymer was mediated by the stability of Cd(II)–N-methacryloyl-L-Histidine complex which was more stable than commonly used monomers including 4-vinyl pyridine, methacrylic acid, and vinylimidazole. The detection limit and relative standard deviation were 0.004 µg L−1 and 3.2%, respectively. The method was validated by the analysis of seawater certified reference material (CASS-4) and successfully used for the determination of Cd(II) in coastal seawater and estuarine water.
Anti-inflammatory New trends in the treatment of the patient with systemic sclerosis

Background: The treatment of systemic sclerosis is a difficult challenge because of the present lack of drugs definitely proven to alter the overall course of the disease. Objective: To address the current guidelines and to analyze the perspectives opened by the availability of new drugs and the identification of previously unknown pathways. Methods: The statements on current treatment are based on recently developed EULAR recommendations. The perspectives reflect the opinion of the authors on emerging topics. Results/conclusion: The treatment of systemic sclerosis has improved in recent years because a number of drugs have been shown to influence single disease manifestations. The identification of previously unknown pathways might open the way for further developments.
Unit roots, structural breaks and cointegration in the UK public finances, 1750–2004

In this article, we report results from several traditional and more recently developed unit root and cointegration tests, allowing for structural breaks, which indicate that UK government revenue and spending during 1750–2004 were I(1) series and cointegrated, and that the UK public finances have been on a consistently sustainable path over the long run.
Laparoscopic partial nephrectomy for hilar tumors.

PURPOSE Partial nephrectomy for hilar tumors represents a technical challenge not only for laparoscopic, but also for open surgeons. We report the technical feasibility and perioperative outcomes of laparoscopic partial nephrectomy (LPN) for hilar tumors. MATERIALS AND METHODS Between January 2001 and September 2004, 25 of 362 patients (6.9%) undergoing LPN for tumor, as performed by a single surgeon, had a hilar tumor. We defined hilar tumor as a tumor located in the renal hilum that was demonstrated to be in actual physical contact with the renal artery and/or renal vein on preoperative 3-dimensional computerized tomography. En bloc hilar clamping with cold excision of the tumor, including its delicate mobilization from the renal vessels, followed by sutured renal reconstruction was performed routinely. RESULTS Laparoscopic surgery was successful in all cases without any open conversions or operative re-interventions. Mean tumor size was 3.7 cm (range 1 to 10.3), 4 patients (16%) had a solitary kidney and the indication for LPN was imperative in 10 patients (40%). Pelvicaliceal repair was performed in 22 patients (88%), mean warm ischemia time was 36.4 minutes (range 27 to 48), mean blood loss was 231 cc (range 50 to 900), mean total operative time was 3.6 hours (range 2 to 5) and mean hospital stay was 3.5 days (range 1.5 to 6.7). Histopathology confirmed renal cell carcinoma in 17 patients (68%), of whom all had negative margins. In 2002 or earlier hemorrhagic complications occurred in 3 patients (12%). No kidney was lost for technical reasons. CONCLUSIONS LPN can be performed in select patients with a hilar tumor. The technical feasibility reported further extends the scope of LPN. To our knowledge the initial experience in the literature is reported.
Shyness 1: Distance Treatment of Social Phobia Over the Internet

Objective: The purpose of the present study was to examine the effectiveness of an Internet-based clinician-assisted computerized cognitive behavioural therapy programme for social phobia. Method: A total of 105 individuals with social phobia were randomly assigned to a six-lesson cognitive behavioural treatment programme or to a waitlist control group. Treatment consisted of four components: six online lessons; homework assignments; participation in an online discussion forum; and regular email contact with a therapist. An intention-to-treat model was used for data analyses. Results: A total of 78% of treatment group participants completed all lessons, and post-treatment data were obtained from 93/105 participants. Significant post-treatment differences between treatment and waitlist participants were found on two measures of symptoms of social phobia. Mean within- and between-group effect sizes (Cohen's d) for the primary social phobia outcome measures were 1.15, and 0.95, respectively. Conclusions: These results were comparable with those obtained in exemplary face-to-face treatment programmes. They provide further positive data about the utility of Internet-based guided self-help programmes for people with common mental disorders.
Mechanical Bowel Obstruction and Related Risk Factors on Morbidity and Mortality

Background: Mechanical bowel obstruction is a common emergency problem resulting in high morbidity and mortality. In this study, we aimed to investigate the clinical presentation and outcome of the patients who underwent surgery due to mechanical bowel obstruction, as well as the effective risk factors on morbidity and mortality. Methods: Between January 2005 and December 2010, 148 patients who underwent surgery with a diagnosis of MBO were evaluated retrospectively. Results: The common cause of mechanical bowel obstruction was benign diseases (79.1%), such as adhesions (48.6%) and sigmoid torsion (15.5%), while 20% of causes were malignancies, like colorectal (16.2%) and small bowel tumors (3.4%). The 56.8% of the patients underwent surgery in the first 24 hours. Intra-operatively, severe ischemic features in the bowel were determined in 48% of the patients, while perforation in 2.7% and necrosis in 7.4%. Resection procedures were performed in 60.1%, while 37.8% of the patients underwent adhesiolysis. Morbidity rate was 41.9%, and 12.8% of the patients had died. While age, comorbidity, etiology, admission time and respiratory complications were the risk factors for mortality, age, comorbidities, admission time, and surgical procedures were effective on morbidity. Independent risk factors were comorbidity and admission time for morbidity and mortality, while age for only mortality. Conclusion: Morbidity and mortality rates may be decreased with considering the etiological causes and the related risk factors of the patients, and increasing the awareness of the public about mechanical bowel obstruction. doi:10.4021/jcs19w
Growth in Young Adults Who Screen Positive for Non-Affective Psychosis: Birth Cohort Study

Objective: While birth cohort studies have shown that individuals who develop non-affective psychosis show subtle deviations in cognitive and behavioural developmental trajectories, there is less evidence about deviations in physical growth in these individuals. The purpose of the present study was to examine the association between behaviour and growth and maturation from infancy, through childhood and adolescence to early adulthood and the development of non-affective psychosis in young adults. Method: Based on a birth cohort of 3801 young adults, weight and length/height were examined at birth and at years 5, 14 and 21, together with pubertal maturation at year 14. Behavioural measures taken at years 5 and 14 were also examined. Screen-positive non-affective psychosis (SP-NAP) was assessed at year 21 using Composite International Diagnostic Interview, or a self-report checklist. The association between the behavioural and growth measures at birth and at years 5, 14 and 21, and SP-NAP at year 21 was examined using logistic regression. Results: There were 60 subjects in the cohort who were classified as having SP-NAP. In female subjects SP-NAP was significantly associated with being longer with a larger head circumference at birth, and less likely to be associated with being shorter at 21 years, with consistent trend associations for height between. There were no differences for weight. There was no significant association between the variables of interest in male subjects or for the total group. There was also no significant association between pubertal development at age 14 and risk of SP-NAP in either sex. Conclusions: Unlike developmental behavioural problems, which showed continuity from childhood through adolescence, SP-NAP was not associated with marked deviations in growth trajectory for male subjects, but the present data suggests that female subjects with SP-NAP had an altered skeletal growth trajectory.