Miracle-dz/UniFAR-FTUs huggingface dataset:
Questioning South Africa's 'genetic link' requirement for surrogacy

and a legal challenge currently being made against SA’s Minister of Social Development, who supports the current law. [3] To begin to appreciate some of the rationale for doubting the justice of the law, consider the following scenario. Imagine a couple that has tried for over a decade to get pregnant, but has been unable to do so. Suppose that he is sterile and she is now in her late 40s, without viable eggs and unable to gestate a fetus. And yet both still long to be involved with a child from the start, perhaps one that is likely to have features similar to theirs. The law, as it stands in SA, forbids them from using a surrogate mother who would carry an embryo fertilised by donor gametes that the couple has selected. In this article I appeal to moral-philosophical reasons to conclude that SA’s surrogacy law is unjust in respect of the above scenario and those similar to it. I rebut rationales, usefully divided into consequentialist and non-consequentialist moral arguments, for
Molecular PET imaging for biology-guided adaptive radiotherapy of head and neck cancer

Abstract Integration of molecular imaging PET techniques into therapy selection strategies and radiation treatment planning for head and neck squamous cell carcinoma (HNSCC) can serve several purposes. First, pre-treatment assessments can steer decisions about radiotherapy modifications or combinations with other modalities. Second, biology-based objective functions can be introduced to the radiation treatment planning process by co-registration of molecular imaging with planning computed tomography (CT) scans. Thus, customized heterogeneous dose distributions can be generated with escalated doses to tumor areas where radiotherapy resistance mechanisms are most prevalent. Third, monitoring of temporal and spatial variations in these radiotherapy resistance mechanisms early during the course of treatment can discriminate responders from non-responders. With such information available shortly after the start of treatment, modifications can be implemented or the radiation treatment plan can be adapted tailing the biological response pattern. Currently, these strategies are in various phases of clinical testing, mostly in single-center studies. Further validation in multicenter set-up is needed. Ultimately, this should result in availability for routine clinical practice requiring stable production and accessibility of tracers, reproducibility and standardization of imaging and analysis methods, as well as general availability of knowledge and expertise. Small studies employing adaptive radiotherapy based on functional dynamics and early response mechanisms demonstrate promising results. In this context, we focus this review on the widely used PET tracer 18F-FDG and PET tracers depicting hypoxia and proliferation; two well-known radiation resistance mechanisms.
Genital herpetic infection association with cervical dysplasia and carcinoma

During a period of 5 1/2 years, 245 patients at Grady Memorial Hospital had cytologic evidence of an active genital herpetic infection. Cervical biopsies obtained in 98 of these patients showed a 23.7% incidence (58 cases) of cervical anaplasia, including 4 cases of invasive and 12 cases of in‐situ squamous cell carcinoma. This is in contrast with the 1.6% overall incidence of cervical anaplasia among a control group of 245 apparently noninfected women of similar age and background and the 2.7% incidence found in the total 56,418 women screened during this period. These findings suggest that either (1) similar factors operate independently to produce both conditions or (2) that the venereally transmitted (type 2) genital herpesvirus plays some etiologic role in precancerous and cancerous cervical lesions. Findings supporting one or the other theory are presented which, however, do not permit any firm conclusion. In either case, the results reported here indicate that women with known genital herpetic infection should be followed closely as a special group with an increased risk of developing cervical anaplastic changes.
Factores de riesgo para complicaciones del recién nacido grande para su edad gestacional

Objective. To explore the relationship between risk factors originated from the mother, labor and the newborn, with the risk of complications in the newborn large for gestational age. Methodology. Analytical study of 170 cases of newborns large for gestational age (LGA), and 260 controls with appropriate weight for gestational age (AGA). Strength of association was estimated through the OR with its respective confidence intervals of 95%. Statistical significance was assumed when the probability value of the studied relationship was under 0.05. Results. 40.0% of the cases versus 13.1% of controls had any kind of complication,
Evidence-based practice and physiotherapy in the 1990s

Physiotherapy emerged as a profession only a century ago and has a fragile, but evolving research evidence base. Physiotherapy has been subject to decades of criticism for its lack of research utilisation, and is often perceived as a profession whose treatment techniques lack scientific support. Numerous editorials and scholarly addresses have urged physiotherapists to become research consumers. The 1990s saw evidence-based practice emerge as a new paradigm within health care and health education, and also the emergence of initiatives like the Cochrane Collaboration, and the UK Department of Health Research and Development initiative, which aim to promote evidence use within the health professions. To determine the extent to which physiotherapy has responded to these criticisms and initiatives this paper presents studies that have explored the fundamental questions of whether physiotherapists read journal literature, implement research findings into practice, and employ scientific documentation and measures. The results of the various studies consistently indicate that despite the numerous initiatives to promote evidence use, many physiotherapy clinicians remain unaware of the extent and nature of published research evidence. The assimilation and utilisation of research literature among physiotherapy clinicians is limited, with the exception of those with higher-degree experience. Journal provision and access to journal clubs within physiotherapy hospital departments is poor. The major factors infl uencing practice were education, prior experience, and peer opinion, rather than research and evidence. Deficiencies in quality and type of documentation also emerged in addition to an apparent unwillingness to employ evidence-based outcome measures. Methods for maximising the positive findings and addressing the deficiencies that emerged are proposed.
Models for Primary Eye Care Services in India

Blindness and visual impairment continues to be a major public health problem in India. Availability and easy access to primary eye care services is essential for elimination of avoidable blindness. ‘Vision 2020: The Right to Sight - India’ envisaged the need for establishing primary eye care units named vision centers for every 50,000 population in the country by the year 2020. The government of India has given priority to develop vision centers at the level of community health centers and primary health centers under the ‘National Program for Control of Blindness’. NGOs and the private sector have also initiated some models for primary eye care services. In the current situation, an integrated health care system with primary eye care promoted by government of India is apparently the best answer. This model is both cost effective and practical for the prevention and control of blindness among the underprivileged population. Other models functioning with the newer technology of tele-ophthalmology or mobile clinics also add to the positive outcome in providing primary eye care services. This review highlights the strengths and weaknesses of various models presently functioning in the country with the idea of providing useful inputs for eye care providers and enabling them to identify and adopt an appropriate model for primary eye care services.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES-NIH STRATEGIC RESEARCH PLAN TO REDUCE AND ULTIMATELY ELIMINATE HEALTH DISPARITIES

The NIAMS has approached the research challenges and opportunities in addressing health disparities by utilizing a broad array of strategies. We have a commitment to maintaining a diverse research portfolio - we invest in our numerous areas using many approaches. Basic research is continuing to uncover many of the most fundamental mechanisms of life and is elucidating strategies for conquering clinical challenges. We take the lessons of basic research and translate them to the clinical arena -- known as "bench to bedside" research. Conversely, research also moves from "bedside to bench," and clinical research can be very useful in providing clues to basic mechanisms. These basic/clinical interactions and translations have served to lay a strong foundation for the present and provide many research opportunities for the future. Research being supported by the NIAMS provides for better diagnosis and treatment, as well as potentially for prevention, of many of the most common, disabling, costly, and chronic diseases compromising life for the American people B diseases that often affect women and minorities disproportionately. Our specific strategies for addressing health disparities in research, research infrastructure, and community outreach are included within each of these sections below.
Providers' Knowledge, Attitude and Dispensing Practices of E-Pills in Government Dispensaries of South District in Delhi, India

Background: South Delhi is one of the well developed districts in the capital with best public health care facilities. Knowledge, attitude and dispensing practices of emergency contraceptive pills (E-pills) were assessed among health care providers of government dispensaries in South Delhi. Study Design: A descriptive epidemiological study. Materials and Methods: Both medical and paramedical (n = 428) providers in 63 government health care facilities were interviewed between August to December 2007 using a semi-structured interview schedule. Results: Among the different categories of the providers, medical officers were observed to be most knowledgeable about E-pills and the pharmacists were the least. The correct prescribed dose of E-pill was known only to 32% of the providers while 49% knew about its right time of intake. Misconceptions and apprehensions for promoting its use were very much prevalent even among medical officers as majority felt that open access to E-pills would increase promiscuity. The dispensing practice of providers was found positively (P < 0.05) correlated with their knowledge. Training resulted a significant (P < 0.05) improvement in knowledge, attitude and dispensing practice of the providers. Knowledge and training combined together contributed 35% to the dispensing practice (R2 = 0.35). Conclusion: Besides knowledge, behavior change communication strategies should form a part of the training curricula of health care providers that would help to improve the dispensing practice of E-pills.
A Comparative Study to Analyze the Cost of Curative Care at Primary Health Center in Ahmedabad

Objectives: To determine the unit cost of curative care provided at Primary Health Centers (PHCs) and to examine the variation in unit cost in different PHCs. Materials and Methods: The present study was carried out in three PHCs of Ahmedabad district namely Sanathal, Nandej, and Uperdal, between 1 April, 2006 and 31 March, 2007. For estimating the cost of a health program, information on all the physical and human resources that were basic inputs to the PHC services were collected and grouped into two categories, non-recurrent (capital resources vehicles, buildings, etc.) and recurrent resources (salaries, drugs, vaccines, contraceptives, maintenance, etc.). To generate the required data, two types of schedules were developed, daily time schedule and PHC/SC (Subcenter) information schedule. Results: The unit cost of curative care was lowest (Rs. 29.43) for the Sanathal PHC and highest (Rs. 88.26) for the Uperdal PHC, followed by the Nandej PHC with Rs. 40.88, implying severe underutilization of curative care at the Uperdal PHC. Conclusions: Location of health facilities is a problem at many places. As relocation is not possible or even feasible, strengthening of infrastructure and facilities at these centers can be taken up immediately.
Faculty Experiences with Integrating Mandated High-Fidelity Human Patient Simulation (HF-HPS) Into Clinical Practice: A Phenomenological Study

Abstract Background High fidelity human patient simulation (HF-HPS) is a teaching innovation in nursing education which may not be used to its full potential. This study seeks to understand the lived experiences of nurse faculty who are required to integrate HF-HPS into their teaching practice. Method A phenomenological methodology was used. Seventeen female nurse faculty teaching in the second year of a new collaborative bachelor of science in nursing program were interviewed about their experiences integrating mandated HF-HPS into their teaching practices. Results Six themes describing the participants’ experiences were identified: striving for self-efficacy, struggling to maintain autonomy, being part of a community of practice, adopting HF-HPS as a teaching innovation, being an advocate, and being proud. An emerging theme, being an outsider, was discussed. Conclusion This research has implications for nurse faculty and educational administrators integrating a new teaching innovation.
Cardiovascular Risk Behavior among Students of a Medical College in Delhi

Background: Life style related behavioural risk factors are mainly implicated for increased burden of cardio- vascular diseases. Research related to these risk behaviours especially among medical students is essential, considering their role as future physicians and role models in public health intervention programmes. Objective: To evaluate the burden of cardiovascular risk behaviours among students of a medical college of Delhi, India. Materials and Methods: A cross sectional study was carried out among undergraduate medical students of a medical college in Delhi. Self administered questionnaire was used to collect information on identification data and risk behaviours in relation to cardiovascular diseases. Binary logistic regression analysis was done to calculate adjusted odds ratio to assess association between risk behaviours and covariates. Results: The minimum recommendation of taking at least five servings per day of fruits and vegetables was complied only by 12% of students. Consumption of carbonated soft drinks either once or more on daily basis was present in 23.7% students and 32.0% reported frequent consumption of fast foods in past week. Consumption of alcohol was present in 28.8% students but only small proportion of students (7%) was current tobacco users. Large proportions of students (42.6%) were either not carrying out or were involved in only occasional physical activity in past week. Conclusions: Unhealthy behavioural practises are present and may progress as student advance through medical college. Developing strategies targeting at these risk behaviours and determining factors is necessary to promote healthy life style among medical students.
American Society of Clinical Oncology Guideline on the Role of Bisphosphonates in Breast Cancer

PURPOSE: To determine clinical practice guidelines for the use of bisphosphonates in the prevention and treatment of bone metastases in breast cancer and their role relative to other therapies for this condition. METHODS: An expert multidisciplinary panel reviewed pertinent information from the published literature and meeting abstracts through May 1999. Additional data collected as part of randomized trials and submitted to the United States Food and Drug Administration were also reviewed, and investigators were contacted for more recent information. Values for levels of evidence and grade of recommendation were assigned by expert reviewers and approved by the panel. Expert consensus was used if there were insufficient published data. The panel addressed which patients to treat and when in their course of disease, specific drug delivery issues, duration of therapy, management of bony metastases with other therapies, and the public policy implications. The guideline underwent external review by selected p.
Apache Flink in current research

Abstract Recent trends in data collection and the decreasing prices of storage result in constantly growing amounts of analyzable data. These masses of data cannot easily be processed by traditional database systems as these do not allow for a sufficient degree of scalability. Programs especially designed for parallel data analysis on large-scale distributed systems are required. Developing such programs on clusters of commodity hardware is a complex challenge for even the most experienced system developers. Frameworks such as Apache Hadoop are scalable, but – when compared to SQL – extremely hard to program. The open-source platform Apache Flink is a link between conventional database systems and big data analysis frameworks. Flink is based on a fault tolerant runtime for data stream processing, which manages the distribution of data as well as communications within the cluster. A high diversity of use cases can be supported through various interfaces that allow for the implementation of data analysis processes. In this paper, we present an overview of Apache Flink as well as some current research activities on top of the Apache Flink ecosystem.
Randomized phase II trial comparing twice daily hyperfractionated with once daily hypofractionated thoracic radiotherapy in limited disease small cell lung cancer

Abstract Background: Concurrent chemotherapy and thoracic radiotherapy (TRT) is recommended for limited disease small cell lung cancer (LD SCLC). Twice daily TRT is well documented, but not universally implemented – probably mainly due to inconvenience and concerns about toxicity. A schedule of three-week hypofractionated TRT is a commonly used alternative. This is the first randomized trial comparing twice daily and hypofractionated TRT in LD SCLC. Material and methods: Patients received four courses of cisplatin/etoposide (PE) and were randomized to TRT of 42 Gy in 15 fractions (once daily, OD) or 45 Gy in 30 fractions (twice daily, BID) between the second and third PE course. Good responders received prophylactic cranial irradiation of 30 Gy in 15 fractions. Results: 157 patients were enrolled between May 2005 and January 2011 (OD: n = 84, BID: n = 73). Median age was 63 years, 52% were men, 84% had performance status 0–1, 72% had stage III disease and 11% non-malignant pleural effusion. The treatment arms were well balanced. The response rates were similar (OD: 92%, BID: 88%; p = 0.41), but more BID patients achieved a complete response (OD: 13%, BID: 33%; p = 0.003). There was no difference in one-year progression-free survival (PFS) (OD: 45%, BID: 49%; p = 0.61) or median PFS (OD: 10.2 months, BID: 11.4 months; p = 0.93). The median overall survival in the BID arm was 6.3 months longer (OD: 18.8 months, BID: 25.1 months; p = 0.61). There were no differences in grade 3–4 esophagitis (OD: 31%, BID: 33%, p = 0.80) or pneumonitis (OD: 2%, BID: 3%, p = 1.0). Patients on the BID arm reported slightly more dysphagia at the end of the TRT. Conclusion: There was no difference in severe toxicity between the two TRT schedules. The twice daily schedule resulted in significantly more complete responses and a numerically longer median overall survival, but no firm conclusions about efficacy could be drawn from this phase II trial.
Pathophysiology of Transluminal Angioplasty

In their original description of the technique, Dotter and Judkins attributed the effectiveness of angioplasty to a redistribution and compression of the atheromatous intima [1]. Recent research, however, has shown that both complex morphologic and physiologic alterations are produced in the vessel wall by angioplasty. In this paper, we review the arterial pathophysiology of angioplasty in order to better understand the basis for its success and failure.
Microbiological evaluation of tissue expanders in patients who had first stage breast reconstruction

Abstract Capsular contracture is one of the most common complications associated to the use of foreign materials in reconstruction after mastectomy and aesthetic breast augmentation. Many risk factors, causes, and conditions seldom associated with capsular contracture have been identified but none of these have been confirmed by published data. Among these, subclinical infections (particularly those caused by Staphylococcus epidermidis) seem to be one of the most likely. In the present study we analysed the correlation between capsular contracture and the incidence of periprosthetic subclinical infection in two groups of patients who had first-stage breast reconstruction: one group of patients who were not having adjuvant or neoadjuvant radiotherapy for breast cancer (n = 25) and a second group of patients who had had quadrantectomy and radiotherapy (QUART) and successive radical mastectomy for recurrent disease (n = 25). Patients who had radiotherapy had a significantly higher incidence of subclinical infection (n = 13) than patients who did not (n = 1), but there was no statistical correlation between subclinical infection and capsular contracture. Subclinical infections seemed to present at a later stage and under certain local and systemic circumstances that favoured bacterial growth, such as radiotherapy.
The development of speech-in-noise perception in Hebrew-speaking school-age children

Abstract Background: Several studies suggest that auditory perception in general and the perception of speech in noise in particular continue to develop until late childhood or early adolescence. It remains unclear, however, whether this prolonged development results from the maturation of the cognitive factors associated with the performance of auditory tasks or from the slow development of auditory sensory processing. Methods: We investigated the perception of monosyllabic words embedded in white noise in Hebrew-speaking school-age children and adults. Results: Although identification thresholds did not become adult-like until 11 years of age, we found no evidence linking this prolonged development to non-sensory factors associated with performance consistency. Conclusions: Therefore, we suggest that similar to the development of amplitude and frequency modulation detection thresholds, this protracted development is related to the maturation of auditory sensory processing.