Miracle-dz/UniFAR-FTUs huggingface dataset:
Psychological Impact of the Physician-Patient Relationship on Compliance: A Case Study and Clinical Strategies

Progress in Transplantation, Vol 12, No. 1, March 2002 Wouldn’t life be easy if all patients followed prescriptions to the letter? If they did well, there would be incontrovertible proof of the efficacy of treatment. If they did poorly, critical variables would have been ruled out and other treatment avenues could be explored. So what stops a patient from complying? Why won’t they listen to sage advice? Why won’t they behave and just do their job—that of a loyal and compliant patient? To facilitate patient compliance we need to move beyond the normative approach to this problem to include a more comprehensive perspective of compliance on the basis of an understanding of the individual patient in the physician’s practice. I provide a case presentation to highlight some of the underlying processes in noncompliance and provide suggestions to help resolve the patient’s resistance and enhance the physician-patient relationship.
Cardiac and renal damage in the elderly hypertensive

JRAAS 2002;3 (suppl 1):S16–S24 Summary In the elderly patient with essential hypertension of long duration or de novo systolic hypertension, the prevalence of co-morbid conditions, be they apparent or not, the burden of associated diseases and the alteration in nutritional status and lifestyle, result in specific problems with regards to hypertension-related target organ damage. Accumulating data suggest that left ventricular (LV) remodelling is a common finding in the normotensive elderly, and that LV hypertrophy (LVH) will herald the development of heart failure in a fraction of patients with either systolic/diastolic or isolated systolic hypertension. Increased arterial stiffness, as well as impaired myocardial relaxation, reduced early diastolic filling and decreased β-adrenergic responsiveness, contribute to the large prevalence of abnormalities in LV function in the elderly hypertensive.The response to exercise is clearly attenuated, and coronary heart disease, although highly prevalent, may be misdiagnosed because symptoms are altered.The elderly hypertensive is exquisitely sensitive to both volume depletion and excessive sodium intake, due to a marked sodium sensitivity of blood pressure (BP). A decline in renal blood flow and glomerular filtration rate (GFR) is a common finding in the elderly. Although structural alterations attributed to age and hypertension may differ, hypertension is often looked upon as an accelerated form of ageing with regards to the heart and the kidney. Lifestyle modifications and initial monotherapy with a low-dose diuretic are warranted in the elderly hypertensive with no co-morbidity; a variety of specific approaches are considered when associated clinical conditions are present. Blockers of the renin-angiotensin system (RAS) may be the preferred first-line agents in many patients with cardiac or renal damage.
The elderly hypertensive population: what lies ahead of us?

JRAAS 2002;3 (suppl 1):S4–S9 Summary In the next 25 years, the population aged 65 years and over will increase by 88%. Thus, postponing the adverse effects of old age for as long as possible will be a major social and economic issue. Hypertension is common in older people, with a prevalence rate of up to 60%, the majority having isolated systolic hypertension. Both isolated systolic hypertension and increased pulse pressure (PP) are associated with a high cardiovascular (CV) risk, and hypertension remains the biggest treatable risk factor for CV disease in the elderly and in the very old. Randomised, controlled trials have demonstrated the benefit of the treatment of hypertension in this population, such that treating just 43 subjects (95% CI: 31–69) for five years would prevent one cerebro-vascular event and treating 61 (95% CI: 39–141) would prevent one coronary event. It should be stressed that antihypertensive treatment reduces both fatal and nonfatal events and will probably prevent the onset of dementia. In other words, it reduces events that represent a major source of disability and handicap in old age and allows healthy ageing. Ongoing trials, which are addressing the preventive effect of treatment in the very elderly hypertensive, will provide further evidence as to the risk/benefit ratio in this ever increasing age group.
Periorbital Edema following Hyaluronic Acid Gel Injection: A Retrospective Review

Introduction: The purpose of this study is to investigate the incidence, clinical features, and treatment of prolonged periorbital edema following the injection of hyaluronic acid gel to the infraorbital hollows. Materials and Methods: Retrospective descriptive study. The medical records of patients from 4 physician practices with prolonged (≥1 month) periorbital edema following the placement of hyaluronic acid gel to the infraorbital hollows, diagnosed between January 1, 2008 and December 31, 2011, were reviewed. Results: A total of 51 charts were reviewed, of which 12 (24%) patients were diagnosed with prolonged periorbital edema with a mean follow-up time of 7.1 ± 4.2 months (range, 1.515.3 months). The mean patient age was 50.4 years (range, 36.464.9 years), and the edema lasted an average of 5.4 months (range, 2.75.3 months). A minority of patients had a preprocedural history of ß uid retention (17%), seasonal allergies (25%), previous lower eyelid or midface surgery (25%), or festoons on examination (0%). Hyaluronidase was used to treat 3 of the 12 affected patients. Conclusions: In this retrospective review of patients undergoing hyaluronic acid gel injection to the periorbital region, prolonged periorbital edema of varying severity occurred in approximately 1 in 4 patients. There were no clinical symptoms or signs prior to injection that consistently identiÞ ed patients susceptible to the edema. Most patients treated with hyaluronidase had successful improvement of their swelling. Hyaluronic acid gel has been increasingly used for periorbital rejuvenation during the past decade. In general, it has an acceptable safety proÞ le, relatively predictable results, and wide patient acceptance. The goal of treatment is to improve the appearance of the region by softening the transition between the eyelid and cheek aesthetic units by adding volume. Temporary complications of hyaluronic acid gel placement include overcorrection or undercorrection, contour irregularities, bruising, and Þ ller visibility with a gray or blue color through the skin (Tyndall effect). Prolonged lower eyelid and malar edema is another recognized complication following the placement of hyaluronic acid gel to the infraorbital region and may be particularly vexing to both patient and physician. This study reports the incidence, clinical features, and treatment of prolonged periorbital edema following the placement of hyaluronic acid gel to the infraorbital hollows during a 3-year period.
Interventions during Donor Care before Lung Transplantation

emia and treatment to improve the PaO2. Conditions that may affect the donor lung (eg, inflammation, infection, edema, or contusion) produce hypoxemia through 1 or a combination of only 3 mechanisms: abnormal coordination of gas and blood flow in the lung (ventilation/perfusion [ · V/ · Q] mismatching), alterations in the normal diffusion pathway for oxygen, Orens et al have published a consensus report from the Pulmonary Council of the International Society for Heart and Lung Transplantation. That report is an excellent review of donor characteristics that may influence the selection of donor lungs and their function after transplantation. The criteria reviewed in that report are shown in Table 1. Orens et al express concern about the “quality” of available research and the need for additional appropriately designed investigations. Current practice standards during organ procurement are often based on recommendations from retrospective observational studies of small numbers of donors. Some characteristics of donors are not amenable to change (eg, the donor’s sex, size, ABO blood type, age, cause of death, smoking history), some characteristics may influence ongoing donor care (eg, smoking history, prior asthma, findings on chest radiographs, duration of mechanical ventilation), and other characteristics may be modified during donor care (arterial blood gas levels, chest radiographic changes, ischemia time, bacterial infection). Conclusions from Orens et al are summarized in Table 2 and suggest that treatment of a low ratio of PaO2 to fraction of inspired oxygen (FIO2) (PaO2:FIO2) may allow more lungs to be accepted and may better support subsequent lung function in the recipient. Treatment of hypoxemia is a common challenge for procurement coordinators even when donor lungs are not being considered. Our intention in this discussion, therefore, is Interventions during donor care before lung transplantation
Health Literacy Skills of Kidney Transplant Recipients

ients in the United States have working grafts. More than 30000 patients are newly enrolled on the transplant waiting list each year, and about 17000 patients annually receive transplants from deceased or living donors. To make an informed treatment choice about obtaining a transplant, all of these patients must understand information about transplant evaluation, surgery, and recovery (of both the recipients and any potential living donors). Specifically, kidney recipients must undergo routine, lifetime physician and laboratory visits, manage a complex immunosuppressant medication regimen, track graft function and fluid intake, vigilantly monitor their vital signs, manage symptoms, exercise, and maintain a low-cholesterol and/or low-salt diet. Additionally, the financial demands of immunosuppression require that kidney recipients manage their finances effectively and interact with insurers, including Medicare. Understanding all of these responsibilities is essential for ensuring the long-term success of the transplant. Despite these knowledge needs, little is known about kidney transplant recipients’ actual knowledge of transplant-related concepts essential for informed consent and self-care management. The limited studies available on kidney recipients document that they vary widely in their knowledge about self-care issues, such as the necessity of communicating with transplant clinicians about travel to developing countries, using sun protection given the high risk of skin cancer, and learning how to take immunosuppressants. Multiple studies indicate that transplant candidates have knowledge deficits about transplantation and living donation. For verbal and written information about transplantation to be understood and integrated into patients’ self-care management, patients must have an adequate level of health literacy. Health literacy refers to an individual’s ability to obtain, process, and understand Health literacy skills of kidney transplant recipients
Space translation properties and the minimum-BER linear-combiner DFE

Decision feedback in a decision feedback equaliser (DFE) performs a space translation that maps the DFE onto a transversal equaliser in the translated observation space. Properties of DFEs can therefore be analysed more easily by exploiting this geometric translation property. This approach is used to analyse the conventional DFE that employs a linear combination of the channel observations and the past decisions (the linear-combiner DFE). It is demonstrated that the usual minimum mean square error (MMSE) solution does not achieve the full performance potential of the linear-combiner DFE structure. A bit error rate (BER) expression for the linear-combiner DFE with binary signalling is obtained, and a method is proposed to optimally set the coefficients of the linear-combiner DFE. The performance of this minimum-BER (MBER) linear-combiner DFE is much closer to that of the optimal Bayesian DFE, compared with the MMSE linear-combiner DFE.
Effects of breakfast and transport method to school on BMI and body fat percentage in children and adolescents

Alice Wiseman Objective: The purpose of this study was to investigate the effects of breakfast habits and transport method to school on Body Mass Index (BMI) and body fat percentage in children and adolescents living in Exeter. Methods: Twenty-three males and 34 females with a mean age of 9.3 ± 2.5 years were recruited from a local primary and secondary school. Questionnaires were used to sort participants into four independent groups active/breakfast eaters, nonactive/breakfast eaters, active/breakfast skippers and non-active/breakfast skippers. Measures of height, weight, BMI and body fat percentage were taken and used to identify subjects who were overweight/over-fat or obese. The data was analysed using SPSS 17.0 to compare the prevalence of overweight and obesity and BMI body fat percentage between groups. Results: One-hundred percent of participants reported eating breakfast on most school days, leaving only two independent groups according to transport status. Primary school children who used non-active methods of transport to school were significantly heavier (30.5 ± 6.49 kg) than those who actively commuted to school (26.3 ± 5.37 kg; p = 0.002). The prevalence of overweight (p = 0.022) and over-fat (p = 0.003) were significantly greater among year 4 children who used non-active transport methods to school (15.4%), compared to those who actively commuted to school (0%). Mean BMI (p = 0.004) and body fat percentage (p = 0.008) were significantly greater among year 4 children who used non-active transport methods to school (17.0 ± 1.37 kg/m2 and 20.6 ± 3.48 %), compared to those who used active transport methods to school (14.6 ± 0.70 kg/m2 and 14.7 ± 3.11). Conclusions: Active transport to school is appears to be protective against overweight and obesity among children in year 4. The effects of active transport to school on BMI and body fat percentage among the whole sample and among other sample subsets are unclear and further research is required to clarify these relationships.
Tumor Necrosis Factor-α Drives 70% of Cigarette Smoke–induced Emphysema in the Mouse

Mice lacking tumor necrosis factor-α (TNF-α) receptors (TNFRKO mice) do not develop an inflammatory infiltrate or matrix breakdown after a single acute cigarette smoke exposure. To determine the role of TNF-α in the long-term development of emphysema, mice were exposed to smoke for 6 months. TNFRKO mice demonstrated an 11% increase in mean linear intercept; wild-type mice had a 38% increase. TNFRKO mice had 65% fewer neutrophils and no increase in macrophages in lavage fluid. Whole lung matrix metalloprotease (MMP)-2, MMP-9, MMP-12, MMP-13, and matrix type-1 (MT1)-MMP proteins were increased in wild-type mice, but smaller increases in MMP-12, MMP-13, and MT1-MMP were also seen in TNFRKO mice. Lavage matrix breakdown products were elevated in wild-type mice and only partially reduced by anti-neutrophil antibody, implying both neutrophil- and non–neutrophil-mediated matrix breakdown. We conclude that TNF-α–mediated processes, probably driving neutrophil influx, are responsible for approximately 70% of airsp.
An Interaction Between User and an Augmented Reality System using A Generalized Finite State Automata and A Universal Turing Machine

Most interactions between users and augmented reality system (ARS) are that user assigns a marker to ARS, and the ARS responds the marker. In this context, a marker is mapped to an ARS's response, or in general, an array of markers is mapped to an array of ARS's responses. This interaction is a constant or linear complexity interaction since there is only a bijective mapping between a set of markers and a set of ARS's responses. In this research, we propose the expansion of user - ARS complexity into the polynomial. It is an interaction in which not only one marker for a single response (or an array of markers for an array of ARS's responses), but the interaction by which user provides a string of markers as a word of markers (i.e., a combination of multiple markers as a word) for a single ARS's response. The set of strings of markers to the ARS provided by users built a regular language. So that, the complexity of the user-ARS interaction became polynomial. This interaction was implemented by stating the user's language by means of a generalization of finite state automata (gFSA) and placing a universal Turing machine (UTM) between user and ARS, where the UTM as an interpreter translating or mapping the user language to ARS. To summarize our research, overall we apply the idea of a formal language into the interaction between the user and ARS, thereby changing the complexity of the interaction to polynomial even expandable to nondeterministic polynomials.
The technique of the exponential change of measure for Markov processes

is a true martingale for a positive function h 2 D(A). We demonstrate that the process X (t) is a Markov process on the probability space (U, F , fF tg, ~ P), we find its extended generator ~ A and provide sufficient conditions under which D(~ A) 1⁄4 D(A). We apply this result to continuous-time Markov chains, to piecewise deterministic Markov processes and to diffusion processes (in this case a special choice of h yields the classical Cameron–Martin–Girsanov theorem).
GSF male and female adult voxel models representing ICRP reference man-The present status

Studies performed by various research groups have shown that the more realistic organ topology of voxel models constructed from medical image data of real persons has an impact on calculated doses for external as well as internal exposures. As a consequence of these findings, the ICRP decided to use voxel models for the forthcoming update of organ dose conversion coefficients. These voxel models should be representative of an average population, i.e. they should resemble the ICRP Reference Man with respect to their external dimensions, their organ topology, and their organ masses. The first step towards a whole family of voxel models covering various age groups was to establish adult male and female voxel models representing the working population. To meet the ICRP requirements, workers at GSF constructed voxel models of a male and female adult, based on the voxel models of two individuals whose body height and weight resembled those of Reference Man. The organ masses of both models were adjusted to the ICRP data on Reference Man, without spoiling their realistic anatomy. The paper describes the method used for this process and the current status of the resulting voxel models.
Replicating Experimental Impact Estimates Using a Regression Discontinuity Approach

This report attempts to replicate the estimated impacts from experimental studies of two different education interventions using a regression discontinuity design. In each case, the estimated impact of the intervention based on the regression discontinuity design was not significantly different from the experimental impact estimate, though the magnitude of the differences between the point estimates of impacts from the two designs sometimes was nontrivial.
Factores de riesgo asociados y sintomatología más común en la diverticulitis aguda complicada

Objective: To know the risk factors and the commonest accompanying symptomatology for the development of complicated acute diverticulitis in a sample of Mexican population. Site: Médica Sur Clinical Hospital and Foundation, third level of attention. Design: Descriptive, retrospective, and transversal study, a series of cases. Statistical analysis: Central-tendency measurements, percentages as a review measurement for qualitative variables. Material and methods: Every patient having been diagnosed with complicated acute diverticulitis was studied during the period going from the years 2000 to 2004. Analyzed variables: age, gender, diet low in fiber, sedentary habits, diarrhea cases and their frequency, body mass index (BMI), abdominal pain, fever and digestive tract bleeding. Results: 187 cases were studied. The 59.35% of them were men, and the 40.65% were women. The age ranged between 50 and 60 years old. The main symptom was abdominal pain in the 87.70% of the cases, followed by fever in the 28.34% of them. Within the main risk factors, sedentary habits were outlined (77%) and a low fiber diet (34.22%). Conclusions: The diagnosis of complicated acute diverticulitis must be suspected among people being between 50 and 60 years old. And presenting abdominal pain, fever, and a background of sedentary life and a diet low in fiber. Resumen. Objetivo: Conocer los factores de riesgo y sintomatología acompañante más comunes para el desarrollo de diverticulitis aguda complicada en una muestra de población mexicana. Sede: Hospital y Fundación Clínica Médica Sur, tercer nivel de atención. Diseño: Descriptivo, retrospectivo, transversal, serie de casos. Análisis estadístico: Medidas de tendencia central, porcentajes como medida de resumen para variables cualitativas. Material y métodos: Se estudiaron todos los pacientes con diagnóstico de diverticulitis aguda complicada, durante el periodo comprendido entre 20002004. Variables analizadas: edad, género, dieta baja en fibra, sedentarismo, estreñimiento crónico, cuadros diarreicos y la frecuencia de los mismos, índice de masa corporal, dolor abdominal, fiebre y sangrado de tubo digestivo. Resultados: Se estudiaron 187 casos. El 59.35% fueron hombres y el 40.65% mujeres. El rango de edad fue entre la quinta y sexta década de la vida. El síntoma principal fue dolor abdominal en el 87.70%, seguido de fiebre 28.34%. Dentro de los principales factores de riesgo destacó el sedentarismo (77 %) y una dieta baja en fibra (34.22% ). Conclusiones: Se debe sospechar el diagnóstico de diverticulitis aguda complicada entre las personas que se encuentran entre la quinta y sexta década de la vida, con dolor abdominal, fiebre y antecedentes de vida sedentaria y dieta baja en fibra. Artemisa medigraphic en línea
Chirurgie prophylactique mammaire et risque génétique: enjeux et conséquences

Patientes indemnes porteuses de mutation Trois types de mastectomie sont actuellement réalisés [1, 2] : la mastectomie totale, la mastectomie avec conservation de l’étui cutané (skin sparing-mastectomy), et la mastectomie avec conservation de la plaque aréolo-mamelonnaire (nipple-sparing mastectomy). Le but de ces trois techniques est de réaliser l’ablation du maximum de tissu glandulaire, sachant que l’origine embryologique du sein et les variations interindividus ne permettent pas de définir de limites anatomiques chirurgicales par rapport aux structures voisines qui assureraient l’exhaustivité de cette exérèse glandulaire.
Enterotoxigenic Escherichia coli infection in childhood diarrhoea in Mombasa, Kenya.

This study was carried out at the Coast General Hospital in Mombasa, Kenya, during the dry month of March, 1984. Stool specimens were collected from 81 infants and children aged 0-36 months and with diarrhea of less than 7 days' duration. 35 age-matched children, who visited the hospitals with complaints other than gastrointestinal, served as controls. None of the children had received previous antibiotic therapy. Stools were checked for enterotoxigenic Escherichia coli (ETEC). E. coli isolates were assayed for labile toxin (LT) and stable toxin (ST) production by the Biken test and the suckling mouse assay, respectively. 19 ETEC were isolated from children with diarrhea, constituting an isolation rate of 23.5%. No ETEC were isolated from the controls. ST producers predominated (94.7%). Results indicate that the rates of ETEC isolation increase with age. In the majority of cases (16/19) ETEC caused diarrhea which was watery, with the number of motions ranging from 3 to 10 times. Fever was present in 9 patients. Mucus and blood were observed in very few cases. Vomiting was frequent (10/19) but abdominal pain was less common (5/10).