Miracle-dz/UniFAR-FTUs huggingface dataset:
Incidence and Risk Factors of Intracranial Hemorrhage in Liver Transplant Recipients

Background Intracranial hemorrhage after liver transplantation is an infrequently reported complication but one which can have devastating consequences. Methods We performed a retrospective cross-sectional analysis of all liver transplants performed between January 2010 and June 2015 at a single high-volume institution using a prospectively maintained electronic database and query of the electronic medical record. Cases of intracranial hemorrhage were adjudicated as either spontaneous intraparenchymal hemorrhage(IPH) or extra-axial hemorrhage (EAH). Patients with confirmed intracranial hemorrhage were compared with all other liver transplant recipients. Risk factors were identified by univariate analysis and logistic regression models for IPH and EAH. Results Thirty-one (5.2%) of 595 liver transplant recipients developed an intracranial hemorrhage within 12 months of transplantation, 15 IPH and 16 EAH. The majority of intracranial hemorrhages were diagnosed within 1 month of transplantation. Eight (26%) intracranial hemorrhage patients died during hospitalization. Fourteen (45%) intracranial hemorrhage patients died within 1 year of transplantation and 1-year mortality was greater than in patients without intracranial hemorrhage (11.2%, P < 0.01). Female sex (adjusted odds ratio [OR], 3.291; 95% confidence interval [CI], 1.092-9.924; P = 0.034), higher pretransplant bilirubin (adjusted OR, 1.037; 95% CI, 1.006-1.070; P = 0.020), and greater increase in pretransplant to posttransplant systolic blood pressure (adjusted OR, 1.029; 95% CI, 1.006-1.052; P = 0.012) were associated with posttransplant IPH. Lower pretransplant serum fibrinogen level (adjusted OR, 0.988; 95% CI, 0.979-0.998; P = 0.017) was associated with posttransplant EAH. Conclusions Postoperative blood pressure control and pretransplant fibrinogen levels may be modifiable risk factors for preventing posttransplant intracranial hemorrhage.
Systemic Lupus Erythematosus: Clinical and Immunologic Patterns of Disease Expression in a Cohort of 1,000 Patients

: In the present study we have analyzed the prevalence and characteristics of the most relevant clinical and immunologic features in 1,000 patients with SLE. Several differences in the expression of the disease have been observed in relation to the patients' age at onset, sex, and autoantibody serology. The childhood-onset patients more often had malar rashes (55% vs 39%) and nephropathy (28% vs 15%) as presenting manifestations. During the evolution of the disease, these patients had an increased prevalence only of malar rash (79% vs 56%) and a lower prevalence of rheumatoid factor (6% vs 19%). The older-onset patients (age 50 or older) less often showed malar rash (21% vs 42%), arthritis (52% vs 71%), and nephropathy (3% vs 17%) as the first symptom. During the evolution of their disease, these patients had a decreased prevalence of malar rash (33% vs 60%), photosensitivity (29% vs 47%), arthritis (73% vs 85%), nephropathy (22% vs 41%), thrombosis (4% vs 15%), and anti-La antibodies (6% vs 20%), but an increased prevalence of sicca syndrome (33% vs 15%). Males more often had serositis (28% vs 16%) as a first symptom, but they presented with a lower prevalence of arthritis (74% vs 85%) during the evolution of the disease. The presence of ANA, a high titer of anti-dsDNA, rheumatoid factor, anti-ENA, and antiphospholipid antibodies also distinguished additional homogeneous SLE subsets of clinical significance.
Assessment of healthy lifestyle habits among Mosul university students

Background: A healthy lifestyle leaves you fit, energetic and at reduced risk for disease, based on the choices you make about your daily habits. Good nutrition, daily exercise and adequate sleep are the foundations for continuing good health. Managing stress in positive ways, instead of through smoking or drinking alcohol, reduces wear and tear on your body at the hormonal level. For a longer and more comfortable life, put together your plan for a healthy lifestyle and live up to it. Objectives: This study was aimed to assess of Healthy lifestyle habits among Mosul University Students and to examine relationship between the university student's characteristics and healthy lifestyles habits. Method: Cross-sectional survey design is applied to assess healthy lifestyle habit among Mosul University Students. Random sample consist of (400) students (Male and Female) were students in Mosul University from specialty difference (College of Medicine, College of Dentistry, College of Nursing, College of Pharmacy, College of Fine Arts, College of Education , College of Basic Education and College of Law),From end stage in University. Period of data collection first December 2013 extended from end February 2014. An interview technique method was used for data collection. Data were analyzed through the application of the descriptive and inferential statistical data analysis. Results: The results of the study indicated that Mosul university students have a low score in the total healthy lifestyle habits, demonstrating that female are higher than that of male(56%). Conclusion: The study concluded that the results are accepted concerning healthy lifestyle habit among Mosul University. After completing this survey, the researcher found that a lot of university students had a big problem of their healthy lifestyle habits, especially eating habits such as they skip breakfast, eat snacks and drink tea a lot.
A qualitative analysis of adolescents' experiences of active and sham Japanese-style acupuncture protocols administered in a clinical trial.

INTRODUCTION Acupuncture is a complex holistic intervention in which patient-practitioner relationships and healing changes occur in interactive, iterative ways. Qualitative research is one way to capture such complexity. This study sought to understand better the experiences of adolescents involved in acupuncture treatment. MATERIALS AND METHODS We included a qualitative substudy as part of a pilot randomized sham-controlled study of the use of Japanese acupuncture to treat chronic pelvic pain in adolescent girls. Seven (7) interviews were attained. Themes were double-coded and analyzed using qualitative analysis software. RESULTS Regardless of treatment arm, all subjects reported positive study-related changes, often attributed to positive qualities of the patient-practitioner relationship. Participants in both the sham and verum acupuncture treatment arms reported in the narratives that they were unsure of their study assignment. In contrast, the study's close-ended success of blinding question suggests that some participants were sure of their treatment allocation. CONCLUSIONS As we continue to study acupuncture using sham controls, we need a better understanding of the possible affects of sham treatments on both treatment outcomes and success of blinding. Qualitative research is one-way to explore subtle emergent changes in participants' experiences.
High-Risk, High-Alert Medication Management Practices in a Regional State Psychiatric Facility

Background The Joint Commission on Accreditation of Healthcare Organizations requires that health care organizations identify high-risk, high alert medications and develop specific processes for enhancing patient safety surrounding their use. Purpose Describe the development and implementation of a clinical pharmacy service, which identifies patients initiated on lithium, clozapine, and warfarin therapy to enable real-time consultation, decrease preventable adverse medication events, and improve the medication-use process. Methods: The facility identified lithium, clozapine, and warfarin for enhanced clinical monitoring. Lithium monitoring criteria include appropriate indication and testing for pregnancy, renal function, electrolyte levels, thyroid function, and serum drug levels. Clozapine monitoring criteria include informed consent, metabolic end points, appropriate indication, and complete blood count monitoring. Warfarin monitoring includes appropriate indication, screening for drug interactions, and international normalized ratio follow-up. Pharmacy and Laboratory information system flags were used to identify at-risk patients. Results For the initial 21 months of implementation, 419 lithium patients were evaluated, with 60.1 % meeting criteria preconsultation, and 95.7% meeting criteria postconsultation. Adverse drug reaction (ADR) reports involving lithium decreased from 6% preimplementation to 3% postimplementation. A total of 76 clozapine-initiation patients were evaluated, with 75% of patients meeting all criteria preconsultation, and 96% meeting criteria postconsultation. Two percent of ADR reports involved clozapine preimplementation, with a decrease to 1% postimplementation. Fifty-six warfarin-initiation therapy patients were followed, with 94.6% meeting all post-pharmacist review criteria. Significant changes were made in the medication dispensing system to prevent warfarin-dose administration errors. Conclusion Pharmacist-facilitated, high-alert medication monitoring plays a significant role in improving the medication-use process in this regional state psychiatric facility.
Determination of catecholamines and their metabolites in rat urine by ultra-performance liquid chromatography-tandem mass spectrometry for the study of identifying potential markers for Alzheimer's disease.

In order to investigate the potential links between catecholamines (CAs) and Alzheimer's disease (AD), rapid and sensitive ultra-performance liquid chromatography (UPLC)-tandem mass spectrometry (MS/MS) methods in different ionization modes for the quantification of 14 CAs and their metabolites in rat urine without derivatization or complex sample pre-treatments were developed. After addition of the internal standard, isoproterenol, the urine samples were extracted by protein precipitation and separated on an Inertsil ODS-EP column (Shimadzu, Japan) at a flow of 1.0 ml min(-1). Tandem mass spectrometric detection was performed on a 4000Q UPLC-MS/MS in the multiple reaction monitoring mode with turbo ion spray source. Tyrosine, dopamine, noradrenaline, epinephrine, 3-methoxytyramine, normetanephrine and metanephrine were determined in positive mode, while 3,4-dihyroxy-L-phenylalanine (DOPA), 3,4-dihydroxyphenylacetic acid, DL-3,4-dihydroxymandelic acid, DL-3,4-dihydroxyphenyl glycol, homovanillic acid, DL-4-hydroxy-3-methoxymandelic acid and 4-hydroxy-3-methoxy-phenylglycol were determined in negative mode. The methods were examined and were found to be precise and accurate within the linearity range of the assays. The intra-day and inter-day precision and accuracy of the analytes were well within acceptance criteria (±15%). The mean extraction recoveries of analytes and internal standard were all more than 60%. The validated methods have been successfully applied to compare CAs profiles in normal and AD rats. The results indicated the urine levels of DL-3,4-dihydroxyphenyl glycol and 4-hydroxy-3-methoxy-phenylglycol in AD rats were significantly higher than those in the normal group, and the other CAs have an opposite performance. These may attribute to the difference of some enzyme activity between rats with AD and normal. Furthermore, this may be helpful in clinical diagnostics and monitor the efficacy of AD treatment.
The invisible dimension in mental health children whose parents suffer from a serious mental illness

Abstract Practice Forum is intended to provide a forum for social work practitioners to share their practice with others; to describe what they are doing and assess its effectiveness. We extend an invitation to all social work practitioners to submit articles for 'Practice Forum' and we look forward to receiving your contribution. Children of mentally ill parents are at high risk of developing mental illness, both for genetic and environmental reasons, and yet, in Victoria at least, no service takes responsibility for addressing their needs. These needs are often complex. They vary according to the age and developmental stage of the child but always require the coordinated response of a number of agencies. Innovative programs in the United States locate the responsibility for this coordination with the adult mental health service caring for the parent. This article describes some of these programs and argues that they represent useful models which should be considered for adaptation in this country.
Paired boxed gene 1 expression: A single potential biomarker for differentiating endometrial lesions associated with favorable outcomes in patients with endometrial carcinoma

Paired boxed gene 1 (PAX1) has previously been reported to be a methylation‐silenced gene in cases of cervical and ovarian cancers. We evaluated the expression of PAX1 in normal endometrium, endometrial hyperplasia and endometrial carcinoma (EC), and investigated the prognostic value of PAX1 expression in patients with EC.
Electron-induced dissociation (EID) for structure characterization of glycerophosphatidylcholine: determination of double-bond positions and localization of acyl chains.

Glycerophospholipids are a highly abundant and diverse collection of biologically relevant lipids, and distinction between isomeric and isobaric species is a fundamental aspect for confident identification. The ability to confidently assign a unique structure to a glycerophospholipid of interest is dependent on determining the number and location of the points of unsaturation and assignment of acyl chain position. The use of high-energy electrons (>20 eV) to induce gas-phase dissociation of intact precursor ions results in diagnostic product ions for localizing double-bond positions and determining acyl chain assignment. We describe a high-resolution, tandem mass spectrometry method for structure characterization of glycerophospholipids using electron-induced dissociation (EID). Furthermore, the inclusion of nomenclature to systematically assign bond cleavage sites with acyl chain position and double-bond location enables a uniform platform for lipid identification. The EID methodology detailed here combines novel application of an electron-based dissociation technique with high-resolution mass spectrometry that facilitates a new experimental approach for lipid biomarker discovery and validation.
THE USE OF WHOLE-BODY CRYOSTIMULATION TO IMPROVE THE QUALITY OF SLEEP IN ATHLETES DURING HIGH LEVEL STANDARD COMPETITIONS

Background This is a field study realized during basketball preparation tournaments for the European championship 2013 with men and women French team. During these competitions, athletes used Whole-Body Cryostimulation (WBC) exposures to enhance their recovery. Objective The aim of this work was to investigate the effects of WBC on the quality of sleep (QS) in athletes during the night following the exposure. Design The preparation took place during one week in a training camp followed by three international matches in three days (one per day). Setting The study was performed with high standard level athletes men and women of the basketball French teams. Participants 27 basketball players participated fully in the study (12 females, 11 males, age: 25.8±3.5 years; weight: 88.5±15.7 kg; height: 192.5±11.8 cm). Risk factor assessment The WBC treatment was 3-min exposure between −110°C and -150°C in the morning or/and in the evening after a training or match session. Main outcome measurements The QS was assessed every day before the exposure with a perceptual scale graduated from 1 “bad sleep” to 5 “restful sleep” adapted from Spiegel's questionnaire. The data were analyzed using paired t-test. Results An improvement in the QS was observed in the night following WBC (3.7±0.7 vs 3.2±0.9, P<.05) compared with what was observed the night without previous WBC. Conclusions Athletes experienced better sleep quality after WBC exposure. Even if the night duration was short during this period, they expressed they had a deeper, quieter and less disturbed sleep. The improvement of the QS during both competition and heavy training load periods appears of importance to enhance athletes' recovery. Such situation may lead to 1) a better standing of the training load, 2) less fatigue before the matches and 3) a decrease of the injury risks.
Polymorphisms of the IL-4, TNF- α , and Fc α RI β Genes and the Risk of Allergic Disorders in At-risk Infants

Polymorphisms in the TNF-alpha (A-308G), IL-4 (C-589T), and Fcalpha RIbeta (E237G) genes have been associated with asthma and related phenotypes. To determine the predictive value of these polymorphisms we have assessed their relative risk (RR) for the development of atopy, asthma, and rhinitis in a high-risk infant population that is being followed longitudinally from birth. DNA was extracted and genotyped for 373 infants and 572 parents for each polymorphism. Phenotypic data were collected for atopy and allergic diseases in the infants at 12 mo of age. The prevalence of these phenotypes in the 281 white infants was compared in each genotypic group. There were no differences in the prevalence of any phenotype between genotypes of the TNF-alpha and Fcalpha RIbeta polymorphisms. However, we found that the IL4-589*T allele was associated with "probable" asthma (RR = 4.1) and that homozygotes for the IL4-589*T allele had an increased risk for the development of rhinitis (RR = 2.4). Using the transmission disequilibrium test, an association of IL4-589*T with atopy was found. We conclude that IL-4-589*T, but not TNF-alpha-308*2 or Fcalpha RIbeta*G, is a risk factor for the development of atopy, asthma, and rhinitis by 12 mo of age.
Advances in Body Composition Assessment

Renowned body composition specialist Timothy Lohman explores the latest issues and controversies in body composition assessment in this reference. After looking at traditional assessment methods, Dr. Lohman contends that new approaches are needed and discusses methods being developed and perfected, including dual energy x-ray absorptiometry, whole-body electrical impedance, total body electrical conductivity, and multicomponent models. "Advances in Body Composition Assessment" also explores the challenges in assessing body composition for children, the elderly, and athletes.
Prenatal diagnosis and successful intrauterine treatment of severe congenital hypothyroidism associated with fetal goiter

Congenital hypothyroidism with fetal goiter is a rare condition associated with severe, but possibly preventable, intrauterine and postnatal complications. Ultrasound examination after 20 weeks of pregnancy enables prenatal diagnosis and early treatment. Due to limited transplacental transport of thyroid hormones, direct intrauterine treatment is needed. So far, only a few reports of fetal goitrous hypothyroidism have been published and no consensus on adequate management exists. We present a case of severe fetal goitrous hypothyroidism diagnosed at 23 gestational weeks treated by sequential intra‐amniotic administration of L‐thyroxin. Treatment resulted in significant goiter reduction and normalization of amniotic hormone levels, and enabled uncomplicated vaginal delivery at term. Current knowledge regarding prenatal diagnosis and intrauterine treatment were unified and applied within this case and a recommendation for clinical practice is provided in this report.
Color vision abnormality as the sole manifestation of posterior reversible encephalopathy due to post‐partum HELLP syndrome

Posterior reversible encephalopathy syndrome (PRES) is associated with several symptoms; of those, visual acuity loss, light oversensitivity (photophobia), and light flashes (photopsia) are known as PRES‐related eye symptoms. We report a post‐partum woman with PRES associated with hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP), in whom color vision abnormality (achromatopsia) was the sole manifestation. Cesarean section was performed at 28 weeks due to headache, epigastralgia, and severe hypertension. HELLP became evident after delivery. On post‐partum day 1, she complained of achromatopsia, stating: “all things look brownish‐gray”. Ophthalmologic examination was normal, but brain magnetic resonance imaging showed occipital lobe lesions, indicative of PRES, and, interestingly, also color vision center (area V4) lesions, suggesting that the achromatopsia had been caused by brain damage. It may be prudent to question HELLP patients concerning achromatopsia.
Psychosocial management of diabetes: Role of diabetes educator

Abstract Despite of the evident need for psychosocial competence and sensitivity in diabetes care professionals, this field remains sub optimally described in both International Diabetes Federation/American Diabetes Association and National Diabetes Educator Program curricula. This unfortunate omission is formidable challenge for diabetes care and poses an urgent need to amend existing curricula for training of diabetes educators (DEs). Diabetes education programs have exhaustively described the hard skills and also mention the importance of behavioral change, communication skills and cultural competence, yet soft skills of addressing psychosocial concerns have been given a Cinderella treatment. Diabetes educator (DE) has to be professional, personal and like a family member to patient forming a valuable link between treating clinician and the people with diabetes (PwD). Looking at the gap and the future aspects, a universal approach of sensitization which includes both the beneficiary and policy makers has to be adopted. Better description and importance of psychosocial aspects of diabetes have to be included in the curricula for DE training.
Preventing Implementation: Exploring Interventions with Standardization in Healthcare

Research on standardization of care and clinical guidelines has found itself struggling with ways of bridging what is often referred to as ‘the gap’ between medical quality as defined in clinical guidelines and the practices of care delivery. Treatment methods and procedures, which have been identified as medically supreme in randomized controlled trials (RCTs) and translated to clinical guidelines, are often not encountered when observing healthcare work in action. The adherence rates of healthcare professionals to clinical guidelines of approximately 50% (Grilli and Lomas, 1994; Burstin; 1999) are frequently seen as problematic by health scientists and policy makers alike. Folders with clinical guidelines are often ironically referred to as ‘paper tigers’: despite their clinical potency, they hardly threaten existing practices of healthcare work. Such observations about low adherence rates are often coupled with a sense of bewilderment about variability and pleas for exploring better strategies for implementing aggregated clinical evidence into the messiness of medical practice (e.g. Cabana et al., 1999; Freeman and Sweeney, 2001). In these quests, integrated care pathways (ICPs) are often presented as potentially fruitful tools for such implementation (Campbell et al., 1998). As I will explore in this paper, this reading of the role of ICPs is an unfortunate one. Whereas pathways originated from the wish to make clinical evidence locally relevant in more dynamic ways, critically scrutinizing both the clinical evidence and the practices of care delivery, the role pathways are nowadays often ascribed fails to recognize the problematic privileging of aggregated medical knowledge over organizational complexity. Ironically, where ICPs were developed to address the ‘implementation problems’ that are produced by an epistemic hierarchy of clinical evidence to which practice is to ‘adhere’, its present conceptualization merely reproduces these problems. Science as Culture Vol. 16, No. 3, 311–329, September 2007