Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Exercise Physiology

Part 1 Introduction to clinical exercise physiology: introduction behavioral approaches to physical activity promotion legal considerations general evaluation and examination skills pharmacotherapy graded exercise testing general exercise prescription development. Part 2 Endocrinology and metabolic disorders: diabetes obesity hyperlipidemia and dislipidemia end stage renal disease. Part 3 Cardiovascular diseases: myocardial infarction revascularization of the heart valvular heart disease chronic heart failure hypertension peripheral vascular disease pacemakers and internal cardiac. Part 4 Diseases of the respiratory system: chronic obstructive pulmonary disease asthma cystic fibrosis. Part 5 Oncology and the immune system: cancer the immune system. Part 6 disorders of bone and the joints: arthritis osteoporosis. Part 7 Selected neuromuscular disorders: non-specific low back pain spinal cord injury multiple sclerosis. Part 8 Special populations: children elderly females.
Assessment of health status of the stone quarry workers in Yelakeli, Wardha district in Central India

Background: Stone Quarry workers in India work in dusty environment and it is an unorganized sector scattered all over India. Various procedure and methods are involved in this work. Respiratory morbidity is commonly associated with this industry.Objective: 1) To Study the socio-demographic profile of stone quarry workers in Wardha district. 2) To assess the health status of stone quarry workers with special reference to respiratory morbidities.Method: A cross sectional study was carried out at a stone quarry in Yelakeli, in Wardha district. It included total 150 workers of which Male: 138, Female: 12. Pulmonary function test was also carried out.Result: Most of the workers 63% of them were between 21 to 40 years of age. 89% of the workers were staying near the stone crushing industry. 68% of the workers were working since less than 5 years. 81% of the workers were not using any protective equipment. Â Smokers had decreased PEFR than the non-smokers, more than 30 years old had decreased PEFR.Conclusion: Many of workers had some or the other health related problems. The significant problems were musculoskeletal problems, eye problems and respiratory problems.
Management and functional outcome of childhood hydrocephalus at the Kenyatta National Hospital

Background: Hydrocephalus is a pathological condition caused by abnormalities of production or absorption of CSF in the brain. The goal of this study was to evaluate the current management and outcome of children (aged 13 years and below) who were treated for hydrocephalus in a single institution in Kenya. Methods: A retrospective analysis was conducted on 200 childrenwho were admitted to the neurosurgical unit at the Kenyatta National Hospital and diagnosed with hydrocephalus between January 2000 and April 2013. The records were analyzed for demographic characteristics, clinical presentation and management variables. Outcome was assessed according to the Glasgow Outcome Scale (GOS) score at the time of discharge from hospital. Results: There were 95 male (47.5%) and 105 female (52.5%) patients. The median age was 3.5 months. 16.5% had associated congenital anomalies, the commonest being spina bifida (18.2%) and dandy walker cyst (18.2%). 162 (81%) of the patients had surgical intervention which included shunts (92.6%), drains (0.6%), therapeutic aspiration (0.6%) and endoscopic third ventriculostomy (6.2%). Good functional recovery was achieved by 94.6% patients whereas residual disabilities accounted for 0.6% and mortality accounted for 4.8%. Conclusion: Outcome depended on initial AVPU score, admission into our Intensive Care Unit and type of management. Surgical management resulted in better outcome but vigilant monitoring for shunt complications is warranted. We recommend follow-up studies using population-based longitudinal data and quantitative quality-of-life measures to identify the specific long-term outcomes including the individual and social impacts of childhood hydrocephalus in Africa. Keywords: Functional outcome, Hydrocephalus, Pediatric neurosurgery
Pseudomonas baetica: pathogenicity for marine fish and development of protocols for rapid diagnosis

Pseudomonas baetica is a pathogen isolated in 2012 from wedge sole (Dicologoglossa cuneata). The aims of this study were (i) to determine the influence of temperature on its virulence, and (ii) to develop specific protocols for rapid diagnosis. Virulence assays carried out by bath using Senegalese sole fry showed that virulence is strongly influenced by temperature: LD50 at 14°C was 8.5 × 105 cfu ml-1 while at 20°C no mortalities were recorded. On the other hand, the high mortality rates observed in virulence assays involving intraperitoneal injection of 2.5 × 105 cfu g-1 suggest that P. baetica may be pathogenic for the five fish species tested (wedge sole, Senegalese sole, sea bream, European sea bass and meagre). Two PCR protocols, using specific primers targeting the gyrB and rpoD genes, were developed for rapid diagnosis from pure cultures. An additional protocol, using both primer sets, was also optimized for detection from fish tissue samples. Specificity was tested using 81 strains from 66 bacterial species, taxonomically and/or ecologically related; only the P. baetica strains showed the expected DNA amplicons. A specific dot-blot assay using polyclonal antibodies was also developed for differentiation of P. baetica from related species. Altogether, the protocols described here will constitute useful tools for diagnosis and clarify the relevance of this pathogen.
Antimullerian hormone levels through the cycles of assisted reproductive techniques: a correlational study

Purpose : The aim of this study was to assess the association of serum antimullerian hormone(AMH) levels in assisted reproductive techniques(ART) cycles with some reproductive measures. Methods : In a cohort study, 60 patients aged 20-40 years who attended as candidates for ART at an infertility clinic were enrolled. Serum levels of follicle stimulating hormone(FSH), E2 and AMH was assessed using blood samples taken on the third menstrual day. Results: Serum FSH was negatively correlated with E2 levels(r=-0.28, P<0.05). AMH was moderately correlated with implantation rate(r=0.6, P<0.001). AMH and FSH were not correlated with BMI, antral follicles or oocyte count. Conclusion: Weak to moderate correlations may exist between AMH and some reproductive factors, but a high prediction power cannot be expected in predicting the pregnancy occurrence for single measurements of AMH.
Muscle metabolism, temperature, and function during prolonged, intermittent, high-intensity running in air temperatures of 33° and 17°C.

Nine unacclimatized university sportsmen performed a prolonged, intermittent, high-intensity shuttle running test in hot (HT) (33 degrees C, dry bulb temperature, approximately 28 %, relative humidity) and moderate (MT) (17 degrees C, 63 %) environmental conditions. Subjects performed 60 m of walking, a 15-m sprint, 60 m of cruising ( approximately 85 % V.O (2max)), and 60 m of jogging ( approximately 45 %V.O (2max)) for 14.8 +/- 0.1 min followed by a 3-min rest, repeated until volitional exhaustion. The hot trial was performed first followed, 14 days later, by the moderate trial. During exercise subjects drank water ad libitum. Subjects ran almost twice as far in the moderate as in the hot trial (HT 11216 +/- 1411, MT 21644 +/- 1629, m, p < 0.01), and the decline in average 15-m sprint performance was greater in the heat (HT, 0.17 +/- 0.05, MT, 0.09 +/- 0.03, s, p < 0.05). Average heart rates, blood lactate and glucose, and plasma adrenaline and noradrenaline concentrations were greater in the HT (main effect trial, p < 0.01), as were serum cortisol concentration (main effect trial p < 0.05, n = 5) and muscle temperature (HT exhaustion vs. same time point in MT, 40.2 +/- 0.3 vs. 39.3 +/- 0.2, degrees C, p < 0.01). Peak torque during knee flexion and extension was not different pre-and post-exercise in the HT. Muscle glycogen utilization tended to be greater in the heat (HT 193.2 +/- 19.5, MT 143.8 +/- 23.9, mmol . kg dry wt (-1), p = 0.055, n = 8). In 7 out of the 8 subjects the increase in utilization was between 19 and just over 200 % greater in the HT. Glycogen remaining in the muscle at exhaustion was greater in the hot than moderate trial (HT 207.4 +/- 34.3, MT 126.5 +/- 46.8, mmol . kg dry wt (-1), p < 0.01, n = 8). Rectal temperature (T (rec)) was higher in the HT at exhaustion than at the same point in time in the moderate trial (HT, 39.60 +/- 0.15 vs. MT 38.75 +/- 0.10, degrees C, interaction trial-time, p < 0.01). There was a very strong negative relationship between rate of rise in T (rec) and distance completed in the HT (HT r = - 0.90, p < 0.01, MT r = - 0.76, p < 0.05). Thus, the earlier onset of exhaustion during prolonged intermittent shuttle running in the heat is associated with hyperthermia. However, while muscle glycogen utilization may be elevated by heat stress, low whole muscle glycogen concentrations would not seem to be the cause of this earlier exhaustion.
Improving the quality of hospital care in America.

Over the past few years, several large studies have shown,1–4 and the Institute of Medicine has emphasized,5 that the quality of health care in the United States is not nearly at the level that we should expect from the world's most expensive health care system. Problems with quality are pervasive throughout both outpatient and inpatient settings and may be responsible for thousands of deaths each year.3,4 In this issue of the Journal, Williams and colleagues,6 from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), present time-series data from their “core measures” program, in which hospitals seeking accreditation .
Immunosuppressive therapy and tolerance of organ allografts.

In this issue of the Journal, three articles describe several organ-transplant recipients in whom allografts have maintained good function for up to 5 years without immunosuppressive treatment.1–3 In two articles concerning combined kidney and hematopoietic stem-cell transplantation, the authors attributed the successful outcome in their patients to the cotransplantation of donor stem cells.1,2 The third report, by Alexander et al., concerns a young girl who received a completely HLA-mismatched liver from a deceased male donor but did not receive a donor stem-cell infusion.3 The cause of the fulminant hepatic failure with which the patient presented was never firmly .
Management of Radial Head Fractures: Current Concepts

Radial head fractures are common injuries and are accompanied by clinically relevant associated injuries in over one-third of patients. They are commonly classified by the Mason classification or one of its modifications. Type I fractures are treated conservatively with early mobilization. Type II fractures can be treated conservatively or by open reduction and internal fixation (ORIF), depending on fragment size and dislocation. Bony restriction in forearm rotation is an indication for surgical treatment. Type III fractures are treated surgically, by means of ORIF, prosthetic replacement or excision. Comminuted fractures with more than three fragments are regarded as unsuitable for ORIF. However, optimal treatment of type II and III fractures is still the subject of debate and there is a strong need for randomized clinical trials and uniform fracture classification and outcome measures.
Preliminary results of gene therapy for retinal degeneration.

In this issue of the Journal, two groups of investigators — Bainbridge et al.1 and Maguire et al.2 — describe the first results of separate clinical trials investigating the short-term safety and preliminary efficacy of gene therapy for Leber's congenital amaurosis. Both groups present short-term data (12 months and 5 months, respectively) on three patients with Leber's congenital amaurosis in each study; the patients were enrolled in trials of recombinant adeno-associated viral delivery of the human retinal pigment epithelium-specific 65-kDa protein gene (RPE65), which was administered as a subretinal injection during vitrectomy. Originally described by Leber in 1869, .
Ezetimibe and cancer--an uncertain association.

The randomized clinical trial is considered to be the most reliable tool to assess the efficacy and safety of new drugs. At times, however, randomized trials detect adverse events that are unanticipated and not easily explained on the basis of current knowledge. An unexpected finding of this kind may ultimately prove to be due to chance, but follow-up studies sometimes confirm the adverse drug effect. Particularly when an unexpected finding raises a safety concern with regard to a drug, physicians face uncertainty about how to act on the information. In this issue of the Journal, we publish the results of .
Implementing Reproducible Research

The self-correcting nature of science has been questioned repeatedly in the decade since Ioannidis (2005), “Why Most Published Research Findings Are False”. The title of the paper, if not the entirety of its content, was widely publicized and called into question whether scientific research was truly contributing to human knowledge and whether public faith in science was misplaced. The existential crisis that ensued within the scientific community identified a lack of replication and reproducibility as a major problem that needed to be addressed.
Rapid Development of Cerebral Atrophy Due to Perinatal Herpes-Simplex Encephalitis

: A case of neonatal herpes simplex virus (HSV) encephalitis is reported in which diffuse cerebral hemorrhagic lesions were seen in the neonatal period. Severe progressive cortical atrophy with parenchymal calcification developed over the subsequent 9 months, resulting in a striking computed tomography (CT) appearance. The range of CT findings in neonatal HSV encephalitis is reviewed, and differential diagnostic considerations in the present case are discussed.
Subjectively-Assigned versus self-reported race and ethnicity in US healthcare

Documenting patient “race” descriptors in clinical medicine, epidemiology, and public health data and analysis has been routine in the US. However, patient race has historically been and is still most often subjectively-assigned rather than self-identified. Even when self-identification is allowed, persons must often self-deny parts of their ancestry by adhering to restrictive race categories. In contrast, most other countries ignore so-called race and may use other ancestral background information including family and geographical histories, language(s) and/or ethnic group(s) membership. We performed two studies involving 160 patients to investigate subjectively-assigned versus self-reported race using a verbal questionnaire in a New Orleans medical clinic. Results revealed that the subjectively-assigned race recorded by the hospital administration/physician was incomplete and therefore inaccurate. Clinicians and researchers must make more accurate and respectful ancestral inquiries in order to derive useful information about individual and population health risks and disease conditions, while also being mindful of potentially erroneous race data previously gathered and conclusions inferred in healthcare literature.
Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial.

Importance For many very low-birth-weight (VLBW) infants, there is insufficient mother's milk, and a supplement of pasteurized donor human milk or preterm formula is required. Awareness of the benefits of mother's milk has led to an increase in use of donor milk, despite limited data evaluating its efficacy. Objective To determine if nutrient-enriched donor milk compared with formula, as a supplement to mother's milk, reduces neonatal morbidity, supports growth, and improves neurodevelopment in VLBW infants. Design, Setting, and Participants In this pragmatic, double-blind, randomized trial, VLBW infants were recruited from 4 neonatal units in Ontario, Canada, within 96 hours of birth between October 2010 and December 2012. Follow-up was completed in July 2015. Interventions Infants were fed either donor milk or formula for 90 days or to discharge when mother's milk was unavailable. Main Outcomes and Measures The primary outcome was the cognitive composite score on the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) at 18 months' corrected age (standardized mean, 100 [SD, 15]; minimal clinically important difference, 5 points). Secondary outcomes included Bayley-III language and motor composite scores, growth, and a dichotomous mortality and morbidity index. Results Of 840 eligible infants, 363 (43.2%) were randomized (181 to donor milk and 182 to preterm formula); of survivors, 299 (92%) had neurodevelopment assessed. Mean birth weight and gestational age of infants was 996 (SD, 272) g and 27.7 (2.6) weeks, respectively, and 195 (53.7%) were male. No statistically significant differences in mean Bayley-III cognitive composite score (adjusted scores, 92.9 in donor milk group vs 94.5 in formula group; fully adjusted mean difference, -2.0 [95% CI, -5.8 to 1.8]), language composite score (adjusted scores, 87.3 in donor milk group vs 90.3 in formula group; fully adjusted mean difference, -3.1 [95% CI, -7.5 to 1.3]), or motor composite score (adjusted scores, 91.8 in donor milk group vs 94.0 in formula group; fully adjusted mean difference, -3.7 [95% CI, -7.4 to 0.09]) were observed between groups. There was no statistically significant difference in infants positive for the mortality and morbidity index (43% in donor milk group, 40% in formula group) or changes in growth z scores. Conclusions and Relevance Among VLBW infants, use of supplemental donor milk compared with formula did not improve neurodevelopment at 18 months' corrected age. If donor milk is used in settings with high provision of mother's milk, this outcome should not be considered a treatment goal. Trial Registration isrctn.org Identifier: ISRCTN35317141.
Islet inflammation in plain sight

Although, diabetes is reaching pandemic proportions, the exact aetiology of either type 1 (T1D) or type 2 diabetes (T2D) remains to be determined. Mounting evidence, however, suggests that islet inflammation is a likely common denominator during early development of either type of the disease. In this review, we highlight some of the inflammatory mechanisms that appear to be shared between T1D and T2D, and we explore the utility of intravital imaging in the study of islet inflammation. Intravital imaging has emerged as an indispensable tool in biomedical research and a variety of in vivo imaging approaches have been developed to study pancreatic islet physiology and pathophysiology in the native environment in health and disease. However, given the scattered distribution of the islets of Langerhans within the ‘sea’ of the exocrine pancreas located deep within the body and the fact that the islets only constitute 1–2% of the total volume of pancreatic tissue, studying the pancreatic islet in situ has been challenging. Here, we focus on a new experimental approach that enables studying local islet inflammation with single‐cell resolution in the relevant context of the in vivo environment non‐invasively and longitudinally and, thereby improving our understanding of diabetes pathogenesis.
Physiology and pharmacology of diabetes therapies in the cat: insulin detemir, insulin glargine, exenatide and the incretin effect

Background: Insulin detemir and insulin glargine are synthetic long-acting insulin analogs. In people, insulin glargine is longer acting and relatively peakless, while insulin detemir has significantly less within-subject variability. Insulin detemir is also associated with less undesired weight gain and decreased frequency of hypoglycemic events. Objectives: To compare the duration of action of insulin detemir and insulin glargine in healthy cats. Animals: Ten young, healthy, neutered, purpose-bred cats Methods: Randomized, cross-over design. Pharmacodynamics of insulin detemir and insulin glargine were determined using the isoglycemic clamp method following a 0.5 U/kg subcutaneous injection. Results: There were no significant differences in the pharmacodynamics of insulin detemir and insulin glargine except for onset of action (mean onset ± SD of insulin detemir 1.8 ± 0.8 hours, mean onset of insulin glargine 1.3 ± 0.5 hours, P = 0.03). End of action of insulin detemir was reached at 13.5 ± 3.5 hours and for insulin glargine at 11.3 ± 4.5 hours. Time to peak action of insulin detemir was reached at 6.9 ± 3.1 hours and
The challenges and needs of older people as HIV and AIDS caregivers in South Africa

In the past decades, older people have become important caregivers for adult children who are sick due to HIV or AIDS, and for grandchildren that stayed alone after the death or disease of one or both parents. This dissertation gives insight in the burden of care that the older people experience and in the psycho-social and socio-economic factors that influence this. The dissertation also describes the development and evaluation of an intervention programme focused on the support of older people with their tasks as caregivers. The results show that after the workshops older people regard themselves more capable of providing care than they did before. Furthermore, cooperation with relevant stake holders in society is necessary for the improvement of structural needs of older caregivers, such as financial assistance and access to social security.
Metered atomisation for respiratory drug delivery

An investigation into the factors affecting the metered atomisation of superheated liquids has been carried out. The investigation was aimed primarily at developing an understanding of the factors which affect the performance of. respiratory drug delivery systems (Suspension Pressurised Metered Dose Inhalers). Initial investigations used a semi-empirical sizing technique, representing the human airways, to identify the major variables (formulation and geometric) which affect the performance of the MDI system. Computer models were developed to describe both continuous and metered discharge from a superheated-liquid aerosol generator. These models were based on the concept of thermal and dynamic equilibrium, but they were improved and extended, to describe metered discharge, by including empirical corrections obtained from continuous discharge experiments. Experimental investigations using 'instrumented inhalers' were used to confirm the validity of the computer model. The experimental investigations encompassed the use of conventional CFC's and the new non-chlorinated propellants 134A and 227. The computer models and droplet correlation function developed during these investigations represent powerful tools for use in the design of both current and future HFC/HFA powered metered dose inhaler delivery systems.
PENGALAMAN MENGHENTIKAN KEBIASAAN MEROKOK PADA MANTAN PEROKOK

Smoking is an unhealthy lifestyle. Effects of smoking not only give the impact to that smokers but also those near the smoker. Quitting smoking requires the support of a healthy conditions. The purpose study to determine the experience of stopping smoking to ex-smokers in the Village of Semarang Tembalang. Qualitative research with a phenomenological approach. Samples carried out with a purposive method, consists of 4 participants. Data collection techniques with in-depth interviews. Result showed that the smokers addicted due to smoking is something that brings pleasure because of the nicotine content. The impact of smoking is a physical disorder, social, economic and psychological. The way to to quit smoking by committing. The kind of support that obtained ex-smokers made up from external, friends and also internal, family.