Miracle-dz/UniFAR-FTUs huggingface dataset:
Maternal anthropometry and pregnancy outcomes in Indonesia

The study was conducted in Bogor, West Java, Indonesia from April 1983 to March 1985. In the study area, the maternal mortality rate was 4.5 per 1000 live births, with an infant mortality rate of 71 per 1000 live births and low birth weight of 14%. The prevalence of anaemia among pregnant women was 50-70%; malaria was not endemic in the study area (1). The subjects of the study were pregnant women residing in the city of Bogor and rural areas close by. Most of the women came from lower to middle socioeconomic classes and represented a social, eco-nomic, and educational stratum that usually receives the services of community health centres. The main objective of the study was to identify indicators of maternal risk at delivery and to develop anthropometric indicators useful for predicting mother and infant outcomes of pregnancy. Data were obtained from women living in 13 non-randomly selected villages and communities in rural and urban areas of Bogor. The villages selected were the most populous in the area. In each village the data were collected from all pregnant women during their first trimester. A total of 2500 deliveries were studied in order to ensure at least 250 LBW infants. All anthropometric measurements were carried out according to the techniques described by Jelliffe (2). Technicians (with at least 5 years experience) carried out joint reliability exercises in the field before the start of the data to ensure adequate precision and accuracy of measurements. Maternal weight was measured using a spring Detec-to balance (120 kg in units of 0.1 kg). Maternal height was measured using a wall-mounted micro-toise height measure (200 cm in units of 0.1 cm). Both maternal and infant arm circumferences were measured using a flexible insert tape (60 cm in units of 0.1 cm). Skinfold thickness was measured with a Harpenden anthropometer (40 mm in units of 1 mm).
Implementation Science: Increasing the Public Health Impact of Audiology Research

Purpose: Implementation science aims to facilitate the use of evidence-based programs, practices, and policies in routine care settings. In audiology, as in other health disciplines, there is a persistent research-to-practice gap. Improving the adoption, reach, implementation, and sustainment of effective interventions in audiology would increase their public health impact, ensuring that all individuals needing hearing health care services could benefit from innovations and evidence-based best practices. This tutorial provides an introductory overview of implementation science relevant to the field of audiology, including Internet-based practices and interventions. Method: Major concepts and themes of implementation science are presented, including implementation outcomes, implementation science frameworks, implementation strategies, current topics in implementation science, and study design considerations. Recent publications in audiology are highlighted to illustrate implementation science concepts and themes. The relevance of each topic to the use of evidence-based programs, practices, and policies in audiology is highlighted with reference to recent research in the field. Conclusions: Challenges in the widespread delivery of evidence-based audiological practices and interventions limit their public health impact. The application of implementation science principles and methods in audiology research, as demonstrated in other areas of health research, can increase our focus on ensuring that effective practices are widely available, accessible, equitable, and sustainable to improve the lives of those who need them.
Predicting the gender difference in depressive symptoms in older adults

Abstract Objectives: The gender difference in depressive symptoms in older adults is well-established, with women exhibiting approximately twice as many depressive symptoms as men across the life span. However, almost no studies have explored why we see this pattern in older adults. Method: In this study, moderation, mediation and reverse mediation analyses were used to learn how gender differences in psychosocial and health variables contribute to the gender difference in depressive symptoms in 60–74 year old participants in the baseline sample of the ORANJ BOWL study (n = 3008). Results: Moderation analyses show that functional ability, health, social support, and living alone interact with gender to predict depressive symptoms. Mediation analyses demonstrate that gender differences in financial comfort, social support, health, functional ability and living alone help explain the gender difference in depression. Reverse mediation analyses show that depressive symptoms also predict the gender difference in psychosocial and health variables. Conclusion: While the moderation analyses show multiple points of entry for clinical implications, they do not provide clarity that explains the gender difference in depressive symptoms. Mediation analyses highlight the roles of functional ability, financial comfort, health and living alone in explaining the gender difference. Reverse mediation analyses suggest a negative feedback loop between depressive symptoms and the predictor variables, with gender differences in functional ability, financial comfort, health and living alone at least partially explained by gender differences in depression. The findings highlight opportunities for targeted depression screening and to identify the gender inequities that need attention in order to reduce disadvantages for women.
Systematic review and meta-analysis examining the relationship between postprandial hypotension, cardiovascular events, and all-cause mortality

ABSTRACT Background Postprandial hypotension (PPH) has been reported to be associated with syncope, falls, adverse cardiovascular outcomes, and increased all-cause mortality. It has been reported to have an incidence as high as 30% in the elderly and persons with diabetes. We therefore performed a meta-analysis to determine the relation of PPH with cardiovascular disease (CVD) events and all-cause mortality. Objectives Our objective was to conduct a systematic review and meta-analysis of cohort and cross-sectional studies to determine the association of PPH with CVD and all-cause mortality. Methods We searched the databases MEDLINE, EMBASE, and Cochrane library up to 13 April 2022 for prospective cohort and cross-sectional studies that examined the association of PPH with CVD outcomes and all-cause mortality. Data were analyzed using the generic inverse variance method with a random-effects model. Grading of Recommendations, Assessment, Development, and Evaluation approach assessed the certainty of evidence. Results Seven studies that included 2389 participants met our inclusion criteria. PPH was associated with each outcome individually, including increased all-cause mortality, total CVD, CVD mortality, and stroke. CVD outcomes and all-cause mortality combined were also associated with PPH (RR: 1.52; 95% CI: 1.05, 2.18; P = 0.03; I2 = 77%). The certainty of evidence was graded as very low due to significant heterogeneity and the limited number of studies. Conclusions This assessment indicates an association of PPH with CVD and all-cause mortality. Further studies are required to improve CVD and mortality estimates, but the potential seriousness of CVD and all-cause mortality as outcomes of PPH justifies more screening, diagnosis, and research.
Motivations for Seeking Laser Tattoo Removal and Perceived Outcomes as Reported by Justice Involved Adults

The goal of this study is to describe reasons for desiring removal of unwanted tattoos and self-reported outcomes among justice-involved adults (JIA) receiving free laser tattoo removal in Southern California. Between 2016 and 2021, JIA completed voluntary anonymous surveys at baseline (n = 53) and follow-up (n = 113) visits. Descriptive analyses were generated for quantitative items. Themes were identified from open-ended questions. Patients were predominantly male (74%) and most (81%) reported tattoo-related discrimination. Adjusted multivariate analyses showed that a higher number of domains in which patients reported tattoo-related discrimination was associated with having more tattoos to remove and citing reasons for removal related to employment and stigma by association (e.g., gang membership and police interactions). At follow-up, 48% of patients felt they were treated better in their community, and nearly a quarter of patients (25%) reported greater confidence and self-esteem. JIA seek tattoo removal due to stigma and discrimination. While JIA reported diverse benefits, tattoo removal should likely be considered as one element of comprehensive programing that addresses JIA’s diverse emotional, social, and economic needs. Longitudinal research is needed to clarify the long-term effects of tattoo removal for JIA.
Motor function and fALFF modulation in convalescent-period ischemic stroke patients after scalp acupuncture therapy: a multi-centre randomized controlled trial

Background: Scalp acupuncture has been found to be effective at improving motor function after ischemic stroke, but few studies examining its central mechanisms of action have been carried out. The aim of this study was to investigate the clinical effects of scalp acupuncture on motor dysfunction and changes in spontaneous brain activity in patients with ischemic stroke. Methods: This was an evaluator- and analyst-blinded, multi-center randomized controlled trial. A total of 108 convalescent-stage ischemic stroke patients with motor dysfunction were allocated to receive either scalp acupuncture combined with rehabilitation treatment (SR group) or rehabilitation treatment alone (RE group). Patients in both groups received treatment 5 times per week for 8 weeks. The primary outcome measure was the Fugl-Meyer assessment (FMA). Secondary outcome measures included the modified Barthel index (mBI), modified Rankin scale (mRS) and values of fractional amplitude of low frequency fluctuation (fALFF) acquired using a resting-state functional magnetic resonance imaging (rs-fMRI) technique. Results: Both groups showed significant improvements in motor function, daily life ability and degree of disability, as measured by FMA, mRS and mBI (p < 0.05), and the SR group showed a significantly greater improvement (p < 0.05). Compared with the RE group, the areas where the fALFF values increased in the SR group were located in the cerebellum, praecuneus, precentral gyrus, superior frontal gyrus and parietal lobe. The improvement in FMA scores had the strongest correlation with the baseline fALFF values of the ipsilateral precentral gyrus. Conclusion: Scalp acupuncture improved motor function in convalescent-period ischemic stroke patients, and effects were correlated with regulation of motor-relevant brain regions. The fALFF value of the ipsilateral precentral and postcentral gyri could be potential clinical indices for prognostication of motor dysfunction. Trial registration number: NCT03120650 (http://www.clinicaltrials.gov).
Patient-level costs of staged unilateral versus immediate bilateral symmetrization mammoplasty in breast-conserving surgery

Abstract Background Following therapeutic mammoplasty (TM), the contralateral breast may require a later balancing procedure to optimize shape and symmetry. The alternative is to offer patients simultaneous TM with immediate contralateral symmetrization via a dual-surgeon approach, with the goal of reducing costs and minimizing the number of subsequent hospital appointments in an era of COVID-19 surges. The aim of this cost–consequence analysis is to characterize the cost–benefit of immediate bilateral symmetrization dual-operator mammoplasty versus staged unilateral single operator for breast cancer surgery. Method A prospective single-centre observational study was conducted at an academic teaching centre for breast cancer surgery in the UK. Pseudonymized data for clinicopathological variables and procedural care information, including the type of initial breast-conserving surgery and subsequent reoperation(s), were extracted from the electronic patient record. Financial data were retrieved using the Patient-Level Information and Costing Systems. Results Between April 2014 and March 2020, 232 women received either immediate bilateral (n = 44), staged unilateral (n = 57) for breast cancer, or unilateral mammoplasty alone (n = 131). The median (interquartile range (i.q.r.)) additional cost of unilateral mammoplasty with staged versus immediate bilateral mammoplasty was €5500 (€4330 to €6570) per patient (P < 0.001), which represents a total supplementary financial burden of €313 462 to the study institution. There was no significant difference between groups in age, Charlson comorbidity index, operating minutes, time to adjuvant radiotherapy in months, or duration of hospital stay. Conclusion Synchronous dual-surgeon immediate bilateral TM can deliver safe immediate symmetrization and is financially beneficial, without delay to receipt of adjuvant therapy, or additional postoperative morbidity.
Which Tendon Plasty Has the Best Outcome? A Comparison of Four Tendon Plasty Techniques in a Large Cohort of Patients with Symptomatic Trapeziometacarpal Osteoarthritis

Background: Trapeziometacarpal osteoarthritis is commonly treated with a trapeziectomy combined with a form of tendon plasty. The type of tendon plasty used is based on the surgeon’s preference. The purpose of this observational study was to compare the outcomes of four different tendon plasties combined with trapeziectomy used to treat osteoarthritis of the trapeziometacarpal joint: the Weilby, Burton-Pellegrini, Zancolli, and anchovy plasty procedures. Methods: Patients treated with a trapeziectomy followed by a tendon plasty completed patient-reported outcome measures at baseline and 12 months postoperatively. The primary outcome was the Michigan Hand Outcomes Questionnaire pain subscale. Secondary outcomes were the minimal clinically important difference of Michigan Hand Outcomes Questionnaire pain scale score, Michigan Hand Outcomes Questionnaire hand function, satisfaction, and complication rate. Results: Seven hundred ninety-three patients underwent a trapeziectomy with a tendon plasty between November of 2013 and December of 2018. There was no difference in pain score after 12 months between the four tendon plasty techniques. Patients undergoing an anchovy plasty had a higher chance of reaching the minimal clinically important difference for Michigan Hand Outcomes Questionnaire pain score compared to the other techniques (OR, 2.3; 95 percent CI, 1.2 to 4.6). Overall, more than 80 percent of the patients were satisfied with the treatment outcome, independent of which technique was used. Complication rates of the different techniques were similar. Conclusions: Surgical treatment of osteoarthritis of the trapeziometacarpal joint reduced pain after 12 months, independent of which tendon plasty was used. Patients undergoing an anchovy plasty were more likely to experience a clinically relevant improvement in pain while having similar hand function, satisfaction, and complication rates. This suggests that anchovy plasty is the preferred tendon plasty. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Prediction of histopathological local staging by radiological findings and differential diagnosis overview in children with nephroblastoma

Background: Nephroblastoma is the most common renal malignancy in children kidney. They are highly heterogeneous tumors with challenging imagistic and histopathological (HP) differential diagnosis. Imaging is critical for understanding local anatomy, staging and for planning surgical approach. Purpose: To determine whether HP staging can be successfully predicted by the imagistic staging using computed tomography. Also, we find it important to make a brief review of the imagistic, HP and immunohistochemical differential diagnosis of nephroblastoma, considering that a correct diagnosis is essential for an appropriate therapeutic strategy in all stages. Patients, Materials and Methods: We present a retrospective study of the medical dossiers of 22 patients that underwent surgery at our Center between 2014 and 2020. We provided descriptive data and compared imagistic and HP staging using a Mann–Whitney U-test. An up-to-date literature review was also done. Results: We found that imagistic staging tends to under- or over-stage at similar rates and that the difference between the two staging systems is statistically significant. Immunohistochemistry is necessary for establishing the correct diagnosis, especially in cases with one predominant HP pattern. Conclusions: HP and imagistic staging are not yet sufficiently similar for successfully predict the former via imagistic means.
Diagnostic uncertainty in patients, parents, and physicians: a compensatory control theory perspective

ABSTRACT Medical diagnoses offer a structure by which psychological uncertainty can be attenuated, allowing patients to diminish psychological threats and focus on health prognosis. Yet when no diagnosis can be made, patients may experience diagnostic uncertainty – perceiving the medical field as unable to provide an accurate explanation of the cause of their health problems. This review examines the psychological threat that diagnostic uncertainty imposes on individuals’ need for control and understanding, and the resulting consequences experienced by patients, parents of pediatric patients, and physicians. Using compensatory control theory as a framework, we propose a taxonomy of behaviors that people may adopt in order to regain control in the face of diagnostic uncertainty and to reaffirm that the world is not random and chaotic. To manage diagnostic uncertainty, people may bolster their personal agency, affiliate with external systems they see as acting in their interest, affirm clear connections between behaviors and outcomes, and affirm nonspecific epistemic structure. Diagnostic uncertainty is approached from the perspectives of patients, parents of pediatric patients, and physicians, demonstrating how each group responds in order to maintain a sense that the world has structure and is not random. Discussion centers on moderators, limitations, and implications for clinical practice.
Predicting severity of cartilage damage in a post-traumatic porcine model: Synovial fluid and gait in a support vector machine

The inflammatory response to joint injury has been thought to play a key role in the development of osteoarthritis. In this preclinical study, we hypothesized that synovial fluid presence of inflammatory cytokines, as well as altered loading on the injured leg, would be associated with greater development of macroscopic cartilage damage after an ACL injury. Thirty-six Yucatan minipigs underwent ACL transection and were randomized to: 1) no further treatment, 2) ACL reconstruction, or 3) scaffold-enhanced ACL restoration. Synovial fluid samples and gait data were obtained pre-operatively and at multiple time points post-operatively. Cytokine levels were measured using a multiplex assay. Macroscopic cartilage assessments were performed following euthanasia at 52 weeks. General estimating equation modeling found the presence of IL-1α, IL-1RA, IL-2, IL-4, IL-6, and IL-10 and MMP-2, MMP-3, MMP-12, and MMP-13 in the synovial fluid was associated with better cartilage outcomes. Higher peak pressure for the surgical hind leg and contralateral hind leg aligned with worse cartilage outcomes. A support vector machine built with synovial fluid and gait metrics also demonstrated cytokine presence was predictive of better cartilage outcomes. In conclusion, this preclinical analysis suggests that synovial fluid devoid of cytokines may be a possible indicator that cartilage is more at risk of becoming pathologic after joint injury.
Using Informatics to Engage Vulnerable Populations in Research: Lessons Learned from the COVID-19 Pandemic

Social distancing and “lockdown” measures introduced by the COVID-19 pandemic created barriers to recruitment and engagement of community members in research activities. Information technology tools were quickly introduced to allow for virtual participation of stakeholders in research. Vulnerable populations, namely communities with limited access to resources or at a higher risk to experience bias or discrimination, were less likely to engage in such virtual research initiatives. Informatics tools have the potential to support these populations, but existing disparities require a careful consideration of engagement strategies. We discuss three case studies of ongoing research projects targeting vulnerable populations and highlight the role of informatics in facilitating engagement. Target populations include family caregivers of hospice patients, low-income older adults and patients with dementia and their families. We describe strategies to overcome unique challenges introduced by the pandemic, and ways to build a more resilient future.
An isoform-selective p38 α MAPK inhibitor rescues early entorhinal cortex dysfunctions in a mouse model of Alzheimer’s disease

Neuroinflammation is a fundamental mechanism in Alzheimer’s disease (AD) progression. The stress-induced activation of the p38 α mitogen-activated protein kinase (MAPK) leads to increased production of proinflammatory cytokines and neurodegeneration. We investigated the effects of an isoform selective p38 α MAPK inhibitor, MW01-18-150SRM (MW150), administered at 2.5 mg/kg/day (i.p.; 14 days) on early entorhinal cortex (EC) alterations in an AD mouse model carrying human mutations of the amyloid precursor protein (mhAPP). We used electrophysiological analyses with long-term potentiation (LTP) induction in EC-containing brain slices and EC-relevant associative memory tasks. We found that MW150 was capable of rescuing LTP in 2-month old mhAPP mice. Acute delivery of MW150 to brain slices was similarly effective in rescuing LTP, with a comparable efficacy to that of the widely used multi-kinase inhibitor SB203580. MW150-treated mhAPP mice demonstrated improved ability to discriminate novel associations between objects and their position/context. Our findings suggest that the selective inhibition of the stress-activated p38 α MAPK with MW150 can attenuate the EC dysfunctions associated with neuroinflammation in an early stage of AD progression.
A critical role for the peroxisome proliferator-activated receptor a (PPAR a ) in the cellular fasting response: The PPAR a -null mouse as a model of fatty acid oxidation disorders

We hypothesized that the lipid-activated transcription factor, the peroxisome proliferator-activated receptor a (PPAR a ), plays a pivotal role in the cellular metabolic response to fasting. Short-term starvation caused hepatic steatosis, myocardial lipid accumulation, and hypoglycemia, with an inadequate ketogenic response in adult mice lacking PPAR a (PPAR a 2 y 2 ), a phenotype that bears remark-able similarity to that of humans with genetic defects in mitochondrial fatty acid oxidation enzymes. In PPAR a 1 y 1 mice, fasting induced the hepatic and cardiac expression of PPAR a target genes encoding key mitochondrial (medium-chain acyl-CoA dehydrogenase, carnitine palmitoyltransferase I) and extramitochondrial (acyl-CoA oxidase, cytochrome P450 4A3) enzymes. In striking contrast, the hepatic and cardiac expression of most PPAR a target genes was not induced by fasting in PPAR a 2 y 2 mice. These results define a critical role for PPAR a in a transcriptional regulatory response to fasting and identify the PPAR a 2 y 2 mouse as a potentially useful murine model of inborn and acquired abnormalities of human fatty acid utilization.