Miracle-dz/UniFAR-FTUs huggingface dataset:
The impact of the economic downturn and health care reform on treatment decisions for haemophilia A: patient, caregiver and health care provider perspectives

Little is known about the impact of the recent US economic downturn and health care reform on patient, caregiver and health care provider (HCP) decision‐making for haemophilia A. To explore the impact of the recent economic downturn and perceived impact of health care reform on haemophilia A treatment decisions from patient, caregiver and HCP perspectives. Patients/caregivers and HCPs completed a self‐administered survey in 2011. Survey participants were asked about demographics, the impact of the recent economic downturn and health care reform provisions on their treatment decisions. Seventy three of the 134 (54%) patients/caregivers and 39 of 48 (81%) HCPs indicated that the economic downturn negatively impacted haemophilia care. Seventy of the 73 negatively impacted patients made financially related treatment modifications, including delaying/cancelling routine health care visit, skipping doses and/or skipping filling prescription. Treatment modifications made by HCPs included delaying elective surgery, switching from higher to lower priced product, switching from recombinant to plasma‐derived products and delaying prophylaxis. Health care reform was generally perceived as positive. Due to the elimination of lifetime caps, 30 of 134 patients (22%) and 28 of 48 HCPs (58%) indicated that they will make treatment modifications by initiating prophylaxis or scheduling routine appointment/surgery sooner. Both patients/caregivers and HCPs reported that the economic downturn had a negative impact on haemophilia A treatment. Suboptimal treatment modifications were made due to the economic downturn. Health care reform, especially the elimination of lifetime caps, was perceived as positive for haemophilia A treatment and as a potential avenue for contributing to more optimal treatment behaviours.
Athletic injuries of the shoulder

This comprehensive text is dedicated to all aspects of diagnosis, treatment, rehabilitation and prevention of injury in the athlete's shoulder. It includes detailed coverage of clinical examination, as well as of imaging of the shoulder, in plain film, ultrasound, angiography and MRI. The book features colour views of arthroscopic techniques detailed in step-by-step fashion. It also provides coverage of surgical and non-surgical management of rotator cuff injuries and shoulder instability.
Asistencia temprana a Salas Cuna y patrones de apego infantil: una revisión

This paper reflects on the infl uence of alternative care in the mother-child attachment. We study the controversial fi ndings that do not allow the kind of infl uence of assistance to Child Care Centers in the first year of life. We review research from 1978 to 2008 on alternative care early and their effect on infant attachment patterns. We review the studies referred mainly to out-of-home care in specialized centers. It develops the definition of alternative care, the importance of adherence and the role of caregivers as a secure base. We review research that focuses on the amount of time in which children are cared for by someone other than the mother, the quality of care and the variables associated with the family and social context. This allows a more comprehensive and complex the effect of alternative care in the development of infant attachment patterns. It discusses the various fi ndings and highlights those of consistency that could contribute to understanding the discussion of the effect of child care centers and their relation to patterns of infant attachment.
Chinese Hemophilia Joint Health Score 2.1 reliability study

To meet the rapidly expanding need for musculoskeletal (MSK) specialists [physiotherapists (PTs), physiatrists] in haemophilia care in China, a 4‐day Train the Trainer workshop was conducted in July/August 2009 in Beijing. A key focus was to train the participants to administer the Hemophilia Joint Health Score (HJHS) version 2.1 for effectively evaluating the MSK health of boys <18 years of age with haemophilia. The aim of this study was to test the HJHS version 2.1 inter‐ and intra‐rater reliability in a group of Chinese PTs and physiatrists with limited experience in haemophilia care. Each of the trained Chinese physiatrists and PTs examined eight boys 4–17 years old with moderate and severe haemophilia on day 1 and repeated the examination on the same patients the next day using the HJHS version 2.1. The boys had a wide range of target joint involvement and arthropathy. The HJHS score sheet, work sheets and manual had been translated into simple Chinese prior to the study. The interrater (ICC 0.90) and intra‐rater (ICC 0.91) reliability was excellent. The internal consistency of the HJHS items was also excellent with Cronbach's alpha of 0.86. With basic training in the administration of the HJHS version 2.1, the tool was reliably administered by Chinese PTs and physiatrists with limited haemophilic experience.
Parental Work Schedules and Child Obesity

Increasing female labour force participation has been a major change in the labour market, but there have been other substantial changes, such as the move to a 24-hour economy. Researchers have found that children were more likely to have emotional or behavioural problems when parents worked non-standard hours (Strazdins et al., 2004). We use the Canadia National Longitudinal Survey of Children and Youth (NLSCY) to study this relationship for child weight status. The NLSCY contains information on maternal and paternal work patterns. We can distinguish between regular daytime schedule or shift, regular evening shift, regular night shift, rotating shift (change from days to evenings to nights), split shift, on call, and irregular schedule. The survey also asks whether the parent usually worked weekends. We use various statistical techniques to examine the relationship between parental work schedules and child weight status.
CANNABIS, UNA OPCIÓN TERAPÉUTICA

RESUMEN Las preparaciones de Cannabis sativa L. tales como marihuana, hashish y dagga, han sido usadas en medicina por varios siglos. Ahora se sabe que el Δ 9 tetrahidrocannabinol (Δ 9 -THC) y sus compuestos relacionados, ejercen una amplia gama de efectos sobre los sistemas inmune, digestivo, reproductivo, ocular, cardiovascular, y nervioso central. La presente revision analiza la literatura disponible relacionada con los efectos terapeuticos de la Cannabis.Palabras clave: medicina, Cannabis, terapeutica, historia, drogas de abuso. CANNABIS, A THERAPEUTIC OPTIONABSTRACT Cannabis sativa L. preparations, such as marijuana, hashish and dagga, have been used in medicine for many centuries. It is now known that Δ 9 tetrahydrocannabinol (Δ 9 -THC) and its related compounds, exert a wide array of effects on the immune, digestive, reproductive, ocular, cardiovascular, and central nervous systems. The present review analyses the literature related to the therapeutic effects of Cannabis.Key words: medicine, Cannabis, therapeutic, history, abused drugs.
Assays for Complement Proteins Encoded in the Class III Region of Human MHC

Investigation of the complement proteins encoded in the class III region of the human MHC isclinically significant. A low level of components that make up the classical pathway is indicative of an underlying in vivo complement activation or primer complement deficiency. Hemolytic tests of C4 and C2 described are the only methods that allow quantitification of the functional complement proteins. The application of these sensitive techniques is unavoidable if inactive complement proteins are present. The complex hemolytic titration process protocol described in detail makes possible the use of this test. Assays to determine complement components belonging to the MHC III region were completed by a basic phenotyping test of the standard factor B alleles. This simple technique is a very useful first‐step assay for clinical laboratories engaged in genetic studies.
In Situ Staining Using MHC Class I Tetramers

The invention of MHC‐tetramer technology to label antigen‐specific T cells has lead to a greatly enhanced understanding of T lymphocyte biology. This protocol describes the use of MHC class I tetramers to stain antigen‐specific T cells in tissue sections. In situ tetramer staining (IST) can be used to determine the localization, abundance, and phenotype of antigen‐specific T cells in native environments and in three‐dimensional space. IST is broadly applicable because it can be used to stain essentially any antigen‐specific T cell in any tissue for which MHC tetramers are available. IST can be combined with histochemistry and/or immunohistochemistry to permit visualization and characterization of antigen‐specific T cells relative to other cell types in stained tissue sections. Thus, IST is a useful and valuable component of MHC‐tetramer technology.
Mouse 4T1 Breast Tumor Model

The 4T1 mammary carcinoma is a transplantable tumor cell line that is highly tumorigenic and invasive and, unlike most tumor models, can spontaneously metastasize from the primary tumor in the mammary gland to multiple distant sites including lymph nodes, blood, liver, lung, brain, and bone The 4T1 tumor has several characteristics that make it a suitable experimental animal model for human mammary cancer. First, tumor cells are easily transplanted into the mammary gland so that the primary tumor grows in the anatomically correct site, as described in this unit. Second, as in human breast cancer, 4T1 metastatic disease develops spontaneously from the primary tumor. Also, the progressive spread of 4T1 metastases to the draining lymph nodes and other organs is very similar to that of human mammary cancer. In this unit, a protocol describes surgical removal of the primary tumor, so that metastatic disease can be studied in an animal setting comparable to the clinical situation where the primary tumor is surgically removed, and metastatic foci remain intact. Another advantage of 4T1 is its resistance to 6‐thioguanine. This property enables precise quantitation of metastatic cells, even when they are disseminated and at sub‐microscopic levels in distant organs, as described here.
Tactile Thresholds are Preserved yet Cortical Sensory Function is Impaired in Chronic Non-Specific Low Back Pain Patients

(Your abstract must use Normal style and must fit in this box. Your abstract should be no longer than 300 words. The box will ‘expand’ over 2 pages as you add text/diagrams into it.) Introduction A substantial amount of evidence points to an alteration in brain structure and function patients with chronic non-specific low back pain (CNSLBP) [1-6]. One interpretation of these findings is that the observed brain changes may represent a disruption of the brain’s representations of the body part and the resultant body perception disturbance may underpin this clinical problem. The current study aimed to investigate sensory dysfunction in CNSLBP. Specifically we aimed to distinguish cortically mediated sensory dysfunction from peripheral dysfunction by comparing simple tactile thresholds with more complex cortically mediated sensory tests Methods We investigated tactile thresholds (TTH), two point discrimination (TPD) and graphaesthesia over the lumbar spine of 19 CLBP patients and 19 age and sex matched healthy controls as a way of investigating whether CLBP patients present with a perceptual disturbance of their lumbar spine. Differences in performance of the sensory tests was explored using the Mann Whitney U Test and one-way between groups multivariate analysis of variance. Results We found no difference in tactile threshold between the two groups (P=.0.751). There was a statistically significant difference between controls and LBP for TPD: F(1,36)=10.15, p=. 003 and letter error rate: F(1, 36)=6.54 p=0.015. The data indicate that LBP patients had a larger lumbar TPD distance and a greater letter recognition error rate. Discussion Both TPD and graphaesthesia are dependant on the integrity of the primary sensory cortex [7]. These data support existing findings of perceptual abnormality in chronic back pain [8] and the preservation of tactile thresholds is suggestive of cortical rather than peripheral sensory dysfunction. Amelioration of these abnormalities may present a target for therapeutic intervention.
Construction of small-insert libraries enriched for short tandem repeat sequences by marker selection.

These protocols construct a representative small-insert genomic DNA library in a phagemid vector. First, size-selected DNA fragments are ligated into a phagemid vector. In the second protocol, the resulting small-insert phagemid library is propagated in a bacterial strain combining mutations at the dut and ung loci, which permit incorporation of uracil in place of thymidine during DNA replication. Infection of the phagemid library with M13 helper phage permits recovery of this library as single-stranded DNA (ssDNA). Finally, this uracil-substituted ssDNA is used as a template for primer extension using an oligonucleotide whose sequence corresponds to the STR class of interest [e.g., (GATA)10] as primer. The products of this primer-extension reaction are transformed into an E. coli strain maintaining wild-type genes at the dut and ung loci. Under these conditions, uracil-substituted ssDNA will be restricted from growing by the host-encoded uracil-N-glycosylase, while the primer-extended products are capable of replicating.
Incidencia de parálisis diafragmática después de cirugía cardíaca

El daño del nervio frénico debido a cirugía cardíaca es la principal causa de parálisis diafragmática en los niños. Determinamos la incidencia de esta afección después de cirugía cardíaca y evaluamos la evolución clínica y tratamiento quirúrgico aplicados a estos pacientes. Se realizó un análisis retrospectivo de 8 pacientes con parálisis diafragmática operados en un período de 26 meses. La incidencia de parálisis diafragmática fue de 8/651(1,2 %). La fístula de Blalock Taussig fue el proceder quirúrgico causante en 4 (50 %) pacientes, lo cual representa una incidencia de 4/63 (6,3 %). El 42,8 % de los pacientes había recibido una cirugía torácica previa. Se realizó plicatura diafragmática a 5 pacientes (62,5%). El tiempo mediano entre cirugía cardíaca y plicatura fue de 3 días (rango 223 días). La mediana del tiempo de ventilación mecánica después de cirugía cardíaca fue de 10 días (rango 5-33 días) en los pacientes con plicatura y de 6 días (rango 19 horas-12 días) en los pacientes sin plicatura (p = 0,39). La edad mediana de los pacientes que requirieron plicatura fue 1 mes (rango 10 días-18 meses), mientras que en los restantes fue de 84 meses (rango 4-100 meses) (p = 0,04). El tiempo mediano entre plicatura y extubación exitosa fue de 3,5 días (rango 3-10 días). La mortalidad en pacientes con parálisis diafragmática fue del 25 % (2 pacientes). La parálisis diafragmática fue una complicación frecuente, y fue la fístula sistémico-pulmonar el proceder quirúrgico asociado más importante. La mortalidad fue elevada a pesar de que la plicatura diafragmática se realizó con relativa precocidad.
Chief dentists' perceived strengths and weaknesses of oral health promotion activities in Malaysia

The main aim of this study is to get the Malaysian chief dentists’ perceptions of the oral health promotion activities currently taking place in their respective states in terms of the strengths and weaknesses of these activities. A qualitative method using an open-ended questionnaire was used to obtain this information. The study samples consist of all the chief dentists in Malaysia who represented a majority of population in their states. The results showed that the main current oral health promotion activities is dental health education talks which aims to disseminate oral health information through health education talks, toothbrushing drills, dental exhibition, pamphlets, brochures and publications. Half of the respondents felt that the commitment of the staff, the support of the public sectors and collaboration with other agencies are the main strengths while the lack of staff and fund has been said as the weaknesses. A range of opportunitieshowever exist to strengthen oral health promotion in Malaysia.
Obstructed Labour in Adigrat Zonal Hospital, Tigray Region, Ethiopia

Background: Obstructed labour is a common cause of maternal and pernatal morbidity and mortality in developing countries. There are few data from Ethiopia, although the problem is believed to be common. Objective: To describe the frequency, causes, complications and treatment outcome of mothers with obstructed labour. Methods: a retrospective (April 1, 1993 – March 30, 2001) review of delivery registration books, operation theatre books and patients records. Results: Of 5,980 hospital deliveries during the study period 195(3.3%) were admitted for obstructed labour. Only 14.1% of all cases had received antenatal care, and the majority (88%) came from rural areas. Mean duration of labour was 45.4 hours for cases of obstructed labour. The most common cause of obstruction was cephalopelvic disproportion (64.9%) followed by malposition/malpresentation (32.5%). Caesarean section was performed in 88 of the 195 cases (46.1%), craniotomy in 31(16.2%), instrumental delivery in 27 (14.1%), hysterectomy in 28(14.6%) and repair of ruptured uterus in 17(8.9%). Maternal and neonatal fatality rates were 3.7% and 55.5% respectively. Serious complication increased with parity. Conclusion: The incidence and complications of obstructed labour are remarkably high. To improve the situation better access to optimal antenatal and intrapartal care, together with early referral of high-risk patients must be facilitated. Ethiop.J.Health Dev. 2003;17(3):175-180
Metaphase Harvest and Cytogenetic Analysis of Malignant Hematological Specimens

Cytogenetic analysis of malignant hematological disease is an important methodology used by clinicians and researchers, as observations of clonal chromosomal abnormalities have been shown to have both diagnostic and prognostic significance. The Basic Protocol describes culture, harvest, and preparation of chromosome spreads from bone marrow aspirates. Three alternate protocols describe adaptations of the Basic Protocol for preparation of specimens from chronic lymphocytic leukemia (CLL) blood/bone marrow, plasma cell disorders, mainly bone marrow multiple myeloma (MM), and “solid” hematological samples including lymph nodes and splenic tissue. The modifications involve slightly different culture and harvest methods that are necessary to assure optimal results. Curr. Protoc. Hum. Genet. 73:10.2. 1‐10.2. 15. © 2012 by John Wiley & Sons, Inc.
The Catalogue of Somatic Mutations in Cancer (COSMIC)

COSMIC is currently the most comprehensive global resource for information on somatic mutations in human cancer, combining curation of the scientific literature with tumor resequencing data from the Cancer Genome Project at the Sanger Institute, U.K. Almost 4800 genes and 250000 tumors have been examined, resulting in over 50000 mutations available for investigation. This information can be accessed in a number of ways, the most convenient being the Web‐based system which allows detailed data mining, presenting the results in easily interpretable formats. This unit describes the graphical system in detail, elaborating an example walkthrough and the many ways that the resulting information can be thoroughly investigated by combining data, respecializing the query, or viewing the results in different ways. Alternate protocols overview the available precompiled data files available for download. Curr. Protoc. Hum. Genet. 57:10.11. 1‐10.11. 26. © 2008 by John Wiley & Sons, Inc.
Clinical Evaluation in Multidisciplinary Settings

Well-integrated multidisciplinary and transdisciplinary assessments can be of significant benefit to children with autism and their families. In this chapter we summarize the range of approaches used depending on the purpose(s) of the assessment as well as the individual's age and level of ability. Attention to integration of findings and incorporation of parents, teachers, and others in the process is reviewed, as are the various challenges faced by multidisciplinary teams. Keywords: assessment; multidisciplinary; transdisciplinary
Gene Delivery to the Airway

This unit describes generation of and gene transfer to several commonly used airway models. Isolation and transduction of primary airway epithelial cells are first described. Next, the preparation of polarized airway epithelial monolayers is outlined. Transduction of these polarized cells is also described. Methods are presented for generation of tracheal xenografts, as well as both ex vivo and in vivo gene transfer to these xenografts. Finally, a method for in vivo gene delivery to the lungs of rodents is included. Methods for evaluating transgene expression are given in the support protocols. Curr. Protoc. Hum. Genet. 78:13.9. 1‐13.9. 41. © 2013 by John Wiley & Sons, Inc.
Discharge recommendation based on a novel technique of homeostatic analysis

Objective: We propose a computational framework for integrating diverse patient measurements into an aggregate health score and applying it to patient stability prediction. Materials and Methods: We mapped retrospective patient data from the Multiparameter Intelligent Monitoring in Intensive Care (MIMIC) II clinical database into a discrete multidimensional space, which was searched for measurement combinations and trends relevant to patient outcomes of interest. Patient trajectories through this space were then used to make outcome predictions. As a case study, we built AutoTriage, a patient stability prediction tool to be used for discharge recommendation. Results: AutoTriage correctly identified 3 times as many stabilizing patients as existing tools and achieved an accuracy of 92.9% (95% CI: 91.6–93.9%), while maintaining 94.5% specificity. Analysis of AutoTriage parameters revealed that interdependencies between risk factors comprised the majority of each patient stability score. Discussion: AutoTriage demonstrated an improvement in the sensitivity of existing stability prediction tools, while considering patient safety upon discharge. The relative contributions of risk factors indicated that time-series trends and measurement interdependencies are most important to stability prediction. Conclusion: Our results motivate the application of multidimensional analysis to other clinical problems and highlight the importance of risk factor trends and interdependencies in outcome prediction.
Determination of Sialylated and Neutral Oligosaccharides in Urine by Mass Spectrometry

This protocol describes a method to allow for the detection of specific oligosaccharide fragments in urine by tandem mass spectrometry. The detection of fragments with specific masses indicates the presence of one of a number of diseases where the deficiency of lysosomal enzymes involved in the degradation of the glyco‐ moieties of glycoproteins is present in the patient. This method describes the derivatization of oligosaccharides present in urine with phenyl‐1‐methylpyrazolone, which renders them hydrophobic, thus allowing desalting with Combi cleanup columns prior to injection. This method allows the detection of storage of oligosaccharides, which may indicate the presence of one of the infantile Pompe disease, α‐mannosidosis, Gm1‐gangliosidosis, Sandhoff disease, sialidosis, galactosialidosis, I‐cell disease, and aspartylglucosaminuria. Curr. Protoc. Hum. Genet. 72:17.10. 1‐17.10. 14 © 2012 by John Wiley & Sons, Inc.