Miracle-dz/UniFAR-FTUs huggingface dataset:
What factors influence physical activity participation in people with rheumatoid arthritis?

Abstract Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by periods of inflammation and remission. Physical activity can reduce disease activity and lower the risks of associated co-morbidities such as cardiovascular disease. Despite the benefits, a high percentage of people with RA do not participate in regular physical activity. Objective: The purpose of this qualitative literature review was to explore and synthesize the experiences of people with RA to develop better insight of the factors that influence physical activity participation. Method: A systematic search was conducted across five online databases; MEDLINE, CINAHL, ScienceDirect, PsycINFO, Web of Science. Studies were assessed for quality, data were extracted and analyzed using thematic synthesis. Results: A total of 186 articles were identified and screened against inclusion/exclusion criteria. Seven studies met the criteria and were included in this review. Five key themes were identified as the most significant factors to physical activity participation: professional knowledge and guidance; part of a community; knowing me, knowing RA; what’s in it for me; and where, when, how much? Professional knowledge and guidance was the underpinning factor influencing physical activity participation. Conclusion: The results identify several internal and external factors that affect physical activity participation. To engage, facilitate and motivate patients to participate in physical activity, ongoing education and support from health care professionals is required. This will promote better symptom management and maintain functional independence. Additionally, health care professionals need to consider individual preferences and abilities when recommending physical activity.
Effect of bupivacaine and adjuvant drugs on skeletal muscle tissue oximetry and blood flow: an experimental study

Background Skeletal muscle microvascular blood flow plays a critical role in many myopathologies. The influence of bupivacaine and adjuvants on skeletal muscle microvascular perfusion and tissue oximetry is poorly understood but might be a relevant risk factor for myopathies after local anesthetic administration. The aim of this experimental study was to determine the effects of bupivacaine alone or in combination with epinephrine or clonidine on skeletal muscle perfusion and tissue oximetry. Methods Combined tissue spectrophotometry and Laser-Doppler flowmetry and tissue oximetry were used to assess local muscle blood flow in anesthetized pigs after topical administration of test solutions (bupivacaine, bupivacaine with epinephrine or clonidine, saline). Measurements were performed for up to 60 mins. Results The application of bupivacaine alone did not alter relative muscle blood flow significantly, whereas the addition of epinephrine or clonidine to bupivacaine resulted in a significant reduction of relative muscle blood flow at T30 and T60. However, bupivacaine resulted in a significant decrease of tissue oximetry values when compared to saline control group at T30 and T60. The application of bupivacaine combined with clonidine or epinephrine resulted in no significant reduction of tissue oximetry when compared to bupivacaine alone. Conclusion Bupivacaine alone results in a significant decrease of tissue oximetry in skeletal muscle which is not increased by the addition of epinephrine or clonidine despite further reductions of microcirculatory perfusion. Overall, bupivacaine alone or with adjuvants does produce local muscle ischemia for which pathological consequences need to be addressed in further studies.
Guide to the Contents of a Cochrane Protocol and Review

This extract is made available solely for use in the authoring, editing or refereeing of Cochrane reviews, or for training in these processes by representatives of formal entities of The Cochrane Collaboration. Other than for the purposes just stated, no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except under the terms of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London W1T 4LP, UK, without the permission in writing of the copyright holders.
Complex effects of childhood abuse, affective temperament, and subjective social status on depressive symptoms of adult volunteers from the community

Background How subjective social status is associated with childhood abuse and affective temperament in the mechanism of depressive symptom exacerbation remains unknown. In this study, we investigated how the complex effects of subjective social status, childhood abuse, and affective temperament influence depressive symptoms in adulthood. Methods Self-report questionnaires were distributed to 853 adult volunteers between January and August 2014. Of them, 404 people gave full consent and returned complete anonymous responses. The following five questionnaires were analyzed: demographic information, Patient Health Questionnaire-9, subjective social status, Child Abuse and Trauma Scale, and Temperament Evaluation of Memphis, Pisa, Paris and San Diego autoquestionnaire. The associations between the scores were analyzed by structural equation modeling. This study was conducted with approval from the ethics committees of Tokyo Medical University and Hokkaido University Hospital. Results Covariance structure analysis demonstrated that childhood abuse and subjective social status did not have a direct effect on adulthood depressive symptoms. Childhood abuse had direct effects on subjective social status and affective temperament and childhood abuse indirectly affected adulthood depressive symptoms through subjective social status and affective temperament. Subjective social status also affected depressive symptoms through an effect on affective temperament. This model explained 43% of the variability in depressive symptoms and the fitness of this model was good. Conclusion Regarding childhood abuse and adulthood depressive symptoms, subjective social status as well as affective temperament may be mediators. The results of this study are expected to contribute to the elucidation of the mechanism of depression.
Anti–Methicillin-Resistant Staphylococcus aureus Nanoantibiotics

Nanoparticle-based antibiotic constructs have become a popular area of investigation in the biomedical sciences. Much of this work has pertained to human diseases, largely in the cancer therapy arena. However, considerable research has also been devoted to the nanochemistry for controlling infectious diseases. Among these are ones due to bacterial infections, which can cause serious illnesses leading to death. The onset of multi-drug-resistant (MDR) infections such as those caused by the human pathogen Staphylococcus aureus has created a dearth of problems such as surgical complications, persistent infections, and lack of available treatments. In this article, we set out to review the primary literature on the design and development of new nanoparticle materials for the potential treatment of S. aureus infections, and areas that could be further expanded upon to make nanoparticle antibiotics a mainstay in clinical settings.
Clinical evaluation of the safety, efficacy and tolerability of sarilumab in the treatment of moderate to severe rheumatoid arthritis

Abstract Rheumatoid arthritis (RA) is an autoimmune disease that is characterised by synovial inflammation and progressive joint disorder with significant pain and stiffness, which lead to functional disability and systemic complications if left untreated. Although methotrexate (MTX) is the cornerstone in the RA therapy, it is ineffective or intolerable in up to 50% of patients. In addition, tumour necrosis factor (TNF) inhibitors which are regarded as the standard of care for those patients, have not been proven a panacea creating a therapeutic gap. In this direction, other cytokines such as the interleukin (IL)-6 in combination with MTX or as monotherapy have been approved. Sarilumab has already been approved for the treatment of moderate to severe RA, but more studies are on their way including polymyalgia rheumatica, giant cell arteritis, juvenile idiopathic arthritis, and indolent systemic mastocytosis. On the other hand, a study was prematurely discontinued after approximately 1.5 years, when the ankylosing spondylitis development program was discontinued due to lack of efficacy. Regarding safety, efficacy and tolerability of the molecule, three pivotal clinical trials have established sarilumab as one of the safe and efficacious choices for the treatment of RA (mobility, target and monarch trials). Significant decreases in progression of structural damage have been demonstrated. Infections and neutropenia are two of the most common adverse events. Sarilumab is beyond any doubt another molecule that can be added to the clinicians’ armamentarium for the treatment of patients with moderate to severe RA with a good safety and efficacy profile.
Neonatal Screening for Congenital Hypothyroidism in Nicaragua: Audit of a Cord-blood Thyrotropin-based Program (2005-2015)

 Abstract The aim of this study is to evaluate the Nicaraguan screening program for congenital hypothyroidism in terms of coverage and effectiveness of detection and confirmation of cases with the condition throughout a decade. Thyrotropin was quantified in cord-blood samples by a validated ELISA and a cut-off of 20 mU/l was applied. Coverage, positive predictive value, recall rate and prevalence were retrospectively analysed. Babies with positive screening results were contacted for confirmation by means of determination of thyrotropin and thyroid profile in serum samples. 272,338 babies were screened during the period 2005-2015. The mean coverage reached by the program in the participating departments was 71%, with a positive predictive value of 83% and a recall rate of 0.055%. Eighty cases of congenital hypothyroidism were identified, representing an incidence of 1 in 3229 live births, most of them (81%) being severe. The performance of the Nicaraguan screening program is comparable to those in Latin America also using cord-blood samples. The incidence of congenital hypothyroidism is within the low range of other countries worldwide. Strategies are needed to expand the program to the whole country, improve recall rates and achieve earlier treatment of babies, with the
Predictors of Major Bleeding and Mortality in Dengue Infection: A Retrospective Observational Study in a Tertiary Care Centre in South India

We conducted a retrospective observational study to describe the clinical profile and outcomes of patients admitted with a diagnosis of dengue fever in a tertiary hospital in South India. A total of 159 patients admitted from April 2014 to October 2018 were included in the study. Vomiting (70.4%), myalgia (60.4%), headache (42.1%), abdominal pain (38.4%), bleeding (38%), and rash (37.1%) were the most common symptoms at presentation. The mean duration of hospital stay was 4.9 days (SD ± 2.4), and the median cost was INR 19,708 ($285) (IQR INR 12,968–32,056 ($188–$305)). Major bleeding was associated with elevated SGOT and SGPT, severe dengue, and secondary dengue. Mortality was associated with elderly age; elevated total leukocyte count, serum bilirubin, serum creatinine, SGOT, and SGPT; and high SOFA score. In view of these observations, we recommend stratifying patients according to the WHO classification of dengue and avoiding the use of thrombocytopenia as a single marker of the severity of the illness.
Chronic respiratory morbidity following viral lower respiratory tract infections in prematurely born infants

Abstract Human meta-pneumovirus (hMPV) and rhinovirus (RV) lower respiratory tract infections (LRTIs) may result in acute symptoms similar to those of respiratory syncytial virus (RSV) LRTI. We, therefore, tested the hypothesis that other viral LRTI, as RSV LRTI, will increase healthcare utilization and chronic respiratory morbidity in prematurely born infants. One hundred and twelve prematurely born infants were followed prospectively. Hospital admissions and general practitioner (GP) attendances were recorded and cough and wheeze documented by diary card. Nasopharyngeal aspirates (NPA) were obtained for every LRTI and analyzed to identify RSV (A and B), hMPV, RV, parainfluenza (1 and 2) and influenza (A and B) viruses. Eighty-four infants suffered 126 LRTIs; 94 viruses [41 RSV, 36 RV, seven hMPV, five parainfluenza (1, 2 or 3) and five influenza (A or B) viruses] were identified from 82 of the 126 NPAs. Compared to the no viral LRTI group, infants with only RSV infection had more (P = 0.038) and longer (P = 0.045) hospital admissions, more GP attendances (P = 0.024), more cough (P = 0.030) and wheeze at follow up (P = 0.018). If infants with dual infections are also considered, however, infants with a hMPV LRTI, with or without other viral RNA being detected, compared to the no viral group, had more hospital admissions (P = 0.005), longer admissions (P<0.001), more GP visits (P = 0.029), more days of cough (P = 0.008) and more days of wheeze (P = 0.004). RSV and possibly hMPV, but not RV, LRTI increase healthcare utilization and respiratory morbidity in prematurely born infants.
Analysis of the clinical characteristics of 176 patients with pathologically confirmed cryptogenic organizing pneumonia

Background Cryptogenic organizing pneumonia (COP), is a form of idiopathic interstitial pneumonia (IIP) and is diagnosed by clinical-radiologic-pathologic (CRP) diagnosis. To summarize the clinical, imaging, pathological, and prognostic characteristics of 176 patients with confirmed COP. Methods Patients who were diagnosed with organizing pneumonia (OP) by lung biopsy between January 1, 2000, and December 31, 2013, in our hospital were retrospectively analyzed and followed up until 12/31/2017. COP was confirmed by CRP diagnosis. Results A total of 1,346 OP cases were identified including 1,170 (86.9%) secondary OP cases (31 cases were originally misdiagnosed as COP but later confirmed as secondary OP during follow-up) and 176 (13.1%) cases of COP. The 176 patients with COP presented with no specific clinical symptoms and chest CT revealed diverse imaging features, such as patchy ground-glass opacity (112/176, 63.6%), consolidation (100/176, 56.8%), nodules (70/176, 39.8%), and fibrous stripes (69/176, 39.2%). The majority of patients (65.3%, 115/176) presented mixed patterns, and 12 (6.8%) showed a reversed halo sign. Of the 176 patients, 83 patients had unilateral lesions (ULs) and did not undergo glucocorticoid therapy. Of the 93 patients with bilateral lesions (BLs), 3 underwent complete resection and were radically cured. The other 90 patients underwent partial resection; of these patients, 37 cases achieved spontaneous remission, and 53 were treated with glucocorticoid therapy. After steroid therapy was reduced or stopped, 35 (66%) patients experienced recurrence. Overall, the 5-year survival rate for the COP patients in our study was 98.3%. Conclusions Our study showed that the majority of the patients pathologically diagnosed as OP had secondary OP (86.9%), with COP accounting for only 13.9% of cases. CRP diagnosis and continuous follow-up may be the key for the accurate diagnosis of COP.
A study on management of paediatric supracondylar humerus fractures with lateral percutaneous Kirschner wire fixation

<p class="abstract"><strong>Background:</strong> Supracondylar fracture of the humerus in children is a common injury encountered in orthopaedic practice. Undisplaced fractures can be managed conservatively, however displaced fractures need proper reduction and adequate fixation for attainment of optimal functional and cosmetic outcomes. The purpose of this study was to evaluate the effectiveness of lateral percutaneous Kirschner (K) wire fixation in the management of displaced supracondylar fractures in relation to achievement of union and functional results. </p><p class="abstract"><strong>Methods:</strong> This was a prospective observational study conducted on 70 patients of either sex with an average age of 5.98 years, presenting to the Orthopaedic Department of S.H. K.M. Government Medical College Hospital, Nalhar, Nuh, Haryana between February 2016 and February 2018, with displaced supracondylar fractures of humerus. All the patients were managed by closed reduction and percutaneous lateral K wire fixation. The patients were followed up for a period of 1 year. The patients were analyzed for union and functional results. <strong></strong></p><p class="abstract"><strong>Results:</strong> All the fractures united with an average time of union of 3.8 weeks. Functional results were assessed using Flynn’s criteria, which were excellent in 58 (82.86%), good in 7 (10%), fair in 3 (4.28%) and poor in 2 (2.86%) patients. </p><p class="abstract"><strong>Conclusions:</strong> Thus results of our study demonstrate that the lateral percutaneous K wire fixation is a safe and effective method of treatment of displaced paediatric supracondylar humerus fractures. </p>
Organizational climate enhance service quality through enhancing OCB in public hospital.

Purpose: For years, research has focused on organizational culture though the organizational climate (OC) is a multidimensional construct. Hospital is a unique organization having unique climate, special for public hospital. This research was a quantitative study, a cross-sectional approach. The sample selected from 150 the employee of public hospitals in Makassar. The data was analyzed by structural equation model (SEM) to test the model of relationship among OC, OCB and SQ. The hypotheses were: 1) There was a relationship of OC to OCB; 2) There was a relationship between OCB and Service quality (SQ); 3) There was a relationship between OC and SQ. Findings: The Confirmatory Factor Analysis (CFA) test presented the loading factor of managerial tools 0,005. The conclusion is OC did not have role in increasing OCB and SQ in public hospital, Makassar. The structural model have to be modified. Research limitations: The sample size was less than 200 and some indicators were invalid. Further research was supposed to apply other dimension of organizational climate and increase the sample size. Originality: The low OCB did not influence employee on providing service quality in public hospital in Indonesia since providing service quality is a mandatory from government.
Fascial neuromodulation: an emerging concept linking acupuncture, fasciology, osteopathy and neuroscience

According to Traditional Chinese Medicine “acupuncture is believed to restore the balance between Yin and Yang” and this can be understood in the Western medicine terminology as a “modulation of the equilibrium between parasympathetic and sympathetic activity”. The vast majority of studies concerning the mechanisms of action of acupuncture have been conducted on its influence on pain, and it has been proposed that acupuncture may indirectly relieve chronic pain by its effects on autonomic nervous system function. Several studies have shown that acupuncture recruits brain networks involved in the integration of multiple other brain functions: for example, the limbic-paralimbic-neocortical network, which plays a major role in modulating the affective dimensions of pain processing and the integration of emotional, sensorimotor, autonomic and immunological functions. It has been recently proposed that mechanical signaling through the connective tissue, along with transmission of the matrix deformation through the fascial system network, can explain the therapeutic effect of acupuncture. This model of acupunture, which involves the transduction of mechanical signals through the connective planes and produces a secondary involvement of neurophysiological mechanism, appears to fit very closely to the ancient model. It is also compatible with the proposed neurophysiological explanation. Furthermore, it appears to be fruitful also in manual therapy approaches. Drawing on the basis of the “Fascial network hypothesis of meridians”, in which there is an overlap between the channels network described by Traditional Chinese Medicine and the newly-defined fascial system, I propose an intervention through a combination of acupoints that have been selected due to their relationship between “extraordinary acupuncture channels”, the myofascial sequences described by Stecco, and the emotional and adaptive function as contemplated by a psychosomatic model used in posturology. This intervention is aimed at treating both stress and postural imbalance.
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Comparison of characteristics of children and adolescents with and without a history of abuse assessed in an urgent psychiatric clinic.

Purpose The objective was 1) to describe the clinical characteristics of children referred for an urgent psychiatric consult with and without, a history of abuse; 2) to study differences in demographic and clinical variables between the groups; and 3) to examine the relationship between different types of abuse and disposition after assessment. Methods This is a 2-year retrospective cohort study of all patients aged 12 to 17 years referred to a hospital urgent psychiatric clinic. Patients were divided into two groups, those with a history of abuse and those without. Study variables included demographics, reason for referral, history of emotional, physical, sexual abuse, substance use, bullying victimization, DSM-5 diagnoses, and disposition. The study population was described using means, frequencies, and percentages, while relationships between types of abuse and clinical and demographic variables were assessed using Mann-Whitney U statistics, Spearman correlations, and logistic regression. Results The prevalence of any type of abuse was 30.4% (227 of 746 referrals). The abused group were older, more likely to be female, to have a history of substance use, bullying victimization, diagnosis of an externalizing disorder, and more likely to be admitted. Among the abused group, males were significantly more likely to report physical/emotional abuse, and female sexual abuse. There was no difference between different kinds of abuse and final diagnoses. Conclusions Almost one-third of children and adolescents referred for urgent psychiatric consultation reported a history of abuse. Awareness of the association between abuse and emergency visits may assist physicians in triaging for urgent psychiatric assessment.