Miracle-dz/UniFAR-FTUs huggingface dataset:
Establishing a pulmonary rehabilitation programme in primary care in Greece: A FRESH AIR implementation study

Pulmonary rehabilitation (PR) is an evidence-based, low-cost, non-medical treatment approach for patients with chronic respiratory diseases. This study aimed to start and assess the feasibility, acceptability and impact of a PR programme on health and quality of life of respiratory patients, for the first time in primary care in Crete, Greece and, particularly, in a low-resource rural setting. This was an implementation study with before–after outcome evaluation and qualitative interviews with patients and stakeholders. In a rural primary healthcare centre, patients with chronic obstructive pulmonary disease (COPD) and/or asthma were recruited. The implementation strategy included adaptation of a PR programme previously developed in United Kingdom and Uganda and training of clinical staff in programme delivery. The intervention comprised of 6 weeks of exercise and education sessions, supervised by physiotherapists, nurse and general practitioner. Patient outcomes (Clinical COPD Questionnaire (CCQ), COPD Assessment Test (CAT), St. George’s Respiratory Questionnaire (SGRQ), Patient Health Questionnaire-9 (PHQ-9), Incremental Shuttle Walking Test (ISWT)) were analysed descriptively. Qualitative outcomes (feasibility, acceptability) were analysed using thematic content analysis. With minor adaptations to the original programme, 40 patients initiated (24 with COPD and 16 with asthma) and 31 completed PR (19 with COPD and 12 with asthma). Clinically important improvements in all outcomes were documented (mean differences (95% CIs) for CCQ: −0.53 (−0.81, −0.24), CAT: −5.93 (−8.27, −3.60), SGRQ: −23.00 (−29.42, −16.58), PHQ-9: −1.10 (−2.32, 0.12), ISWT: 87.39 (59.37, 115.40)). The direct PR benefits and the necessity of implementing similar initiatives in remote areas were highlighted. This study provided evidence about the multiple impacts of a PR programme, indicating that it could be both feasible and acceptable in low-resource, primary care settings.
IMPACT OF JOB DISSATISFACTION ON PERFORMANCE OF THE GRAMA NILADHARI OFFICERS IN KALUTARA DIVISIONALSECRETARIAT IN SRI LANKA

Job Satisfaction is a crucial psychological factor affecting the motivation of employees. Various studies have found that Job Satisfaction is an essential condition for enhancing the productivity of employees. Only a few studies in the literature examine the Job Satisfaction of Public Sector Officers in Sri Lanka. This study relates to Job Satisfaction of the Grama Niladhari Officers who serve at the grass root level of the public service in Sri Lanka. An initial investigation indicated that the Grama Niladhari officers in the Kalutara Divisional Secretariat in Sri Lanka are dissatisfied with their job. The main focus of this study is to examine whether the Grama Niladhari Officers in Sri Lanka are really dissatisfied? What is the level of their dissatisfaction? What are the reasons for their dissatisfaction and the impact of dissatisfaction on their performance? This research was based on the qualitative research methods and data were collected from twenty Grama Niladhari Officers in the Kalutara Divisional Secretariat in Sri Lanka by using a convenient sampling method. Interview method was used to gather field data. The data were analyzed descriptively with the researchers‟ and the respondents‟ interpretations. The study has developed several measures to explain different levels of dissatisfaction of the Grama Niladhari officers as „Strongly Dissatisfied‟, Dissatisfied‟ and „Neither Dissatisfied nor Satisfied‟. The majority of the sample of the Grama Niladhari Officers is in the category of „Dissatisfied‟ with their job regarding Payments, Promotion, Political Influence, Recognition, Technology and Training. Based on the lessons learnt, a theoretical framework has been derived based on the analysis to explain factors affecting dissatisfaction of the Grama Niladhari Officers in the Kalutara Divisional Secretariat in Sri Lanka. This study found that the dissatisfaction level of the Grama Niladhari Officers has negatively affected their performances. Finally, recommendations are suggested to minimize the Job Dissatisfaction level of the Grama Niladhari Officers in the Kalutara Divisional Secretariat in Sri Lanka. Keyword: Job Dissatisfaction, Grama Niladhari Officers, Public Service, Kalutara Divisional Secretariat For full paper: fmscresearch@sjp.ac. lk
Safety of the 9-Valent Human Papillomavirus Vaccine

We describe reports of AEs after 9vHPV submitted to the VAERS after its initial licensure. BACKGROUND: The 9-valent human papillomavirus vaccine (9vHPV) was approved for females and males aged 9 to 26 years in 2014. We analyzed postlicensure surveillance reports to the Vaccine Adverse Event Reporting System (VAERS). METHODS: We searched VAERS data for US reports of adverse events (AEs) after 9vHPV from December 2014 through December 2017. We calculated reporting rates and conducted empirical Bayesian data mining to identify disproportional reporting. Physicians reviewed reports for selected prespecified conditions. RESULTS: VAERS received 7244 reports after 9vHPV: 31.2% among females, 21.6% among males, and for 47.2%, sex was not reported. Overall, 97.4% of reports were nonserious. Dizziness, syncope, headache, and injection site reactions were most commonly reported; the most commonly reported AEs were similar between females and males. Two reports of death after 9vHPV were verified; no information in autopsy reports or death certificates suggested a causal relationship with vaccination. Approximately 28 million 9vHPV doses were distributed during the study period; crude AE reporting rates were 259 reports per million 9vHPV doses distributed for all reports and 7 per million doses distributed for serious reports. Syncope (a known AE associated with human papillomavirus vaccination) and several types of vaccine administration errors (eg, administered at wrong age) exceeded the statistical threshold for empirical Bayesian data mining findings. CONCLUSIONS: No new or unexpected safety concerns or reporting patterns of 9vHPV with clinically important AEs were detected. The safety profile of 9vHPV is consistent with data from prelicensure trials and from postmarketing safety data of its predecessor, the quadrivalent human papillomavirus vaccine.
Proportion of Retinopathy of Prematurity That Was Treated across Regions in the United States

Abstract Objectives Retinopathy of prematurity (ROP) is the leading preventable cause of blindness in children worldwide. Major eye and visual problems are strongly linked to ROP requiring treatment. Objectives of the study are to: (1) evaluate the trends and regional differences in the proportion of treated ROP, (2) describe risk factors, and (3) examine if treated ROP predicts mortality. Study Design Retrospective data analysis was conducted using the Kids' Inpatient Database from 1997 to 2012. ROP was categorized into treated ROP (requiring laser photocoagulation or surgical intervention) and nontreated ROP. Bivariate and multivariate logistic regression analyses were performed. Results Out of 21,955,949 infants ≤ 12 months old, we identified 70,541 cases of ROP and 7,167 (10.2%) were treated. Over time, the proportion of treated ROP decreased (p = < 0.001). While extremely low birth weight infants cared for in the Midwest was associated with treated ROP (adjusted odds ratio [aOR] = 29.05; 95% confidence interval [CI]: 10.64–79.34), black race (aOR = 0.57; 95% CI: 0.51–0.64) care for in the birth hospital (aOR = 0.44; 95% CI: 0.41–0.48) was protective. Treated ROP was not associated with mortality. Conclusion The proportion of ROP that is surgically treated has decreased in the United States; however, there is variability among the different regions. Demographics and clinical practice may have contributed for this variability.
Evidence of Saffold virus circulation in Italy provided through environmental surveillance

Saffold virus (SAFV) is an emerging human cardiovirus associated with respiratory and gastrointestinal infection, and, more recently, to symptoms related to the endocrine, cardiovascular, and neurological systems. Information about SAFV circulation in Italy is scarce. In order to provide insights into the epidemiology of SAFV in Italy, 141 raw sewage samples collected throughout Italy were tested using broad‐range nested RT‐PCR primers targeting the 5′‐NC region. Seven samples (5·0%) were confirmed as SAFV in samples collected in North, Centre and Southern Italy. Typing was attempted through amplification of the VP1 coding region, using both published and newly designed primers, and one sample was characterized as SAFV‐2.
Transition and retention in human services: An exploratory study of the first year

This paper reports on an exploratory study which examined a sample of Australian human service students’ perceptions of adjustment and retention during the first year. This study concerned itself with ascertaining whether there were any discipline-specific impacts on retention for this group. From analysis of the results, it was found that human service students experienced the same types of impacts on retention as research in other fields has reported. Particularly, the juggling of multiple responsibilities could impact adversely on retention and completion. The findings add further support to offering a range of strategies to boost first year retention.
Hysterectomy versus GnRH agonist for dysfunctional uterine bleeding in premenopausal women

Dysfunctional uterine bleeding (DUB) in premenopausal women is a common problem leading to medical or surgical intervention. The aim of this study was to compare GnRH agonist and hysterectomy in treatment of DUB in premenopausal women. In a randomized clinical trial, 250 patients of age, 40 to 55 years with complaint of abnormal uterine bleeding resistant to routine medications were enrolled into the study. Ninety seven patients after ruling out organic, was randomized to receive either hysterectomy or 4 doses of diphereline. Two groups followed up 6 and 24 months after intervention. From 97 patients, 85 accomplished the study. Bleeding stopped in 91.8% of patients after 2nd dose of diphereline, which is beyond 6 and 24 months, 73.33 and 40.9% had amenorrhea, respectively. There were no significant differences between two groups in pelvic pain, mastalgia, sleep disorders, sexual function, stress incontinence and urgency after 2 years follow up. Low back pain, urinary frequency and depression were significantly higher in patients that underwent hysterectomy (P = 0.03, P = 0.03 and P < 0.001, respectively). There was more satisfaction of treatment (67.5% versus 44.4%, P = 0.004) and better quality of life after 2 years (34.1% versus 16.7%, P = 0.08) in diphereline group. GnRH agonist is an appropriate alternative to hysterectomy for treatment of DUB in premenopausal women.
Equine grass sickness

EQUINE grass sickness (dysautonomia) is a neurological disease associated primarily with degeneration of neurons in the autonomic nervous system (including the enteric nervous system), although involvement of the somatic nervous system has also been widely reported. It affects all Equidae, is usually fatal and has an approximate incidence of 1 per cent in some parts of the UK. This article discusses the clinical aspects of the disease and summarises the findings of recent research into the aetiology and epidemiology of the condition.
Learning Approaches of Nursing Students of Rizal Technological University Using the revised Two-Factor Study Questionnaire

Research has shown that academic success in student is related to how students approach the learning of educational materials. A student who aimed at making the material meaningful by associating it with previous experience and learning is generally associated with higher quality outcomes. However, approaches to learning had not been explored in other areas of the education system especially if it correlates with the success or failure of a student taking the licensure examination. This study aimed to determine the learning approaches of the nursing students of Rizal Technological University whether they adapt a surface or deep approach to learning. It also explored the difference of the learning approaches among the year level; the difference between the deep and surface scores of the students and the relationship of the senior students’ approach to learning, in respect to the passing or failing in the 2009 nursing licensure exam. The Revised Two Factor Study Process Questionnaire (R-SPQ-2F; Biggs, Kember & Leung, 2001) was utilized to measure surface and deep approach of 92 students from the College of Nursing with 23 students representing their year level. Results showed that the senior students’ ranks first in the deep approach while sophomore students’ ranks first in the surface approach. The students were more inclined to a deep approach in learning as they reach their senior year and similarly, having a deep approach to learning is not an assurance that a student will make to the licensure exam. Implications for learning and teaching were also discussed.
Risk Factors for Jumper’s Knee

VIII LIST OF PUBLICATIONS XII DEFINITIONS XIII ABBREVIATIONS XIV 1. INTRODUCTION 1 1.1 ANATOMY OF PATELLAR AND QUADRICEPS TENDON 1 1.1.1 Elements of human tendons 2 1.1.2 Extracellular matrix 3 1.1.3 Tendon cells 4 1.2 TENDON BIOMECHANICS AND PROPERTIES 5 1.2. 1 Tendon adaptation to mechanical loading 6 1.2. 2 Short term training effects 11 1.2. 3 Long-term training effects 12 1.3 PATHOLOGY 13 1.3. 1 Jumper’s knee diagnosis 13 1.3. 2 Epidemiology of jumper’s knee 15 1.3. 3 Imaging of pathological tendons 19 1.3. 4 Histopathological findings 21 1.3. 5 Molecular findings 22
A Biosecurity measures application with proper treatment to overcome the risk factors that limit effective control of subclinical mastitis in dairy buffalo farms-A field study

Subclinical mastitis is one of the most costly diseases of dairy animals. This field study was carried out on 100 milking buffalo-cow aged from 2 to 7 years old in a herd group and housed at a private farm in El-Fayoum governorate, Egypt, from July, 2012 to March, 2013, (whereas decreased in milk yield, old infection by mastitis was treated systemically, workers don't check animals for mastitis periodically and had knowledge about clinical mastitis but none of them knew about subclinical mastitis plus low hygienic measures), aiming to determine: the prevalence rate of subclinical form of mastitis (SCM), monthly incidence of the disease post calving, isolation of caused pathogens and assessment of their susceptibility to commonly used antibiotics, cure rate after proper treatment in conjunction of improvement of both environmental and hygienic measures surrounded the animals to understand the constraints that limit effective control of the disease. A total of 400 quarter milk samples were collected from 100 milking buffaloes and screened for subclinical mastitis by the aid of California Mastitis Test (CMT), 108 positive CMT quarters related to 58 % of farm's animals suffering from SCM , hind quarters were most affected (66.7%). The CMT positive quarter samples, bulk milk samples, swabs of milk containers and tanks, water pipes and tanks, bedding and milker's hands were cultured for isolation of the causative bacterial agents. Escherichia coli was the most frequently isolated pathogen (25.92%) followed by Staph aureus (22.23%), coagulase negative Staphylococci (CNS) (6.48%)) and Clostridium perfringens type A (1.85%). The mixed growth was (43.52%) between S. aureus , E.coli and streptococcus spp. and staphylococcus spp. Antibiogram analysis was carried out for bacterial isolates where Enrofloxacin, Cefotaxime, Amoxicillin and clauvilinic acid; were found the most effective drugs against the major of isolated strains in our study. Resistance of S. aureus to penicillin is more prevalent. It could be concluded that both environmental and hygienic measures surrounded the animals constitute a major risk factors in the occurrence of mastitis. So, continuous bacteriological investigation together with treatment, and increase hygienic measures were done in the present study in order to identify potential mastitis control measures. (Nahed, M. A. Shawky; Dalia, K. Eskander; Ahlam, K.A.Wahba; Abeer, A.E.M. Mohamad. A Bio-security measures application with proper treatment to overcome the risk factors that limit effective control of subclinical mastitis in dairy buffalo farms-A field study. Nat Sci 2013; 11(7):140-151). (ISSN: 1545-0740). http://www.sciencepub. net/nature . 24
A Case of Pulsatile Tinnitus with High Jugular Bulb Treated by Ligation of Internal Jugular Vein

Objective tinnitus due to high jugular bulb is a rare presenting symptom. Annoying pulsatile tinnitus caused by high jugular bulb which may cause sleep disturbance or hearing impairment can be treated by surgical therapy of ligation of internal jugular vein. We present a case of pulsatile tinnitus with high jugular bulb which has been treated by surgical therapy. Otologic examination demonstrated bluish mass in hypotympanic portion behind intact tympanic membrane and temporal bone CT showed the high jugular bulb. Audiological characteristics and the nature of tinnitus was also described. After the angiographic examination, the site for venous ligation was confirmed by compression of internal jugular vein with the probe of doppler sonogram. The patient’s pulsatile tinnitus has completely disappeared two weeks after surgery. (Korean J Otorhinolaryngol-Head Neck Surg 2007;
Crimean-Congo Hemorrhagic Fever: A Threat for Housewives

Crimean-Congo Hemorrhagic Fever (CCHF) is a tick-born disease. It is usually transmitted to man following a tick bite or through contact with the blood of an infected patient or blood-contaminated specimens. The mortality rate of CCHF is up to 30%. Five cases of our 7 cases had contacted with livestock or their products. Malaise was the most frequent complaint and fever placed in the second position. Leukopenia, thrombocytopenia and transaminase increases reported in all seven cases. All patients were treated with oral Ribavirin. Both RT-PCR and ELISA tests on serum samples were positive in all cases. As seen in this study and similar studies contact with livestock and animal products is one of the main factors in the transmission of the disease. So, we can conclude that education and awareness of higher risk groups can play a significant role in reducing the risk of being infected with the virus.
Noninvasive Diagnosis of Coronary Artery Stenosis in Women with Limited Exercise Capacity* Comparison of Dobutamine Stress Echocardiography and 99m Tc Sestamibi Single-

coronary artery stenosis in women. Patients: Seventy women with limited exercise capacity referred for evaluation of myocardial ischemia. Methods: DSE (up to 40 mg/kg/min) was performed in conjunction with stress MIBI SPECT. Resting MIBI images were acquired 24 h after the stress test. Ischemia was defined as new or worsened wall motion abnormalities confirmed by DSE and as reversible perfusion defects confirmed by MIBI. Significant coronary artery disease was defined as > 50% luminal diameter stenosis. Results: DSE was positive for ischemia in 35 of 45 patients with coronary artery stenosis and in 2 of 25 patients without coronary artery stenosis (sensitivity 5 78% CI, 68 to 88; specificity 5 92% CI, 85 to 99; and accuracy 5 83% CI, 74 to 92). A positive MIBI study for ischemia occurred in 29 patients with coronary artery stenosis and in 7 patients without coronary artery stenosis (sensitivity 5 64% CI, 53 to 76; specificity 5 72% CI, 61 to 83; and accuracy 5 67% CI, 56 to 78 [p < 0.05 vs DSE]). In the 59 vascular regions with coronary artery stenosis, the regional sensitivity of DSE was higher than MIBI (69% CI, 62 to 77 vs 51% CI, 42 to 59, p < 0.05), whereas specificity in the 81 vascular regions without significant stenosis was similar (89% CI, 84 to 94 vs 88% CI, 82 to 93, respectively). Conclusion: DSE is a useful noninvasive method for the diagnosis of coronary artery stenosis in women and provides a higher overall and regional diagnostic accuracy than dobutamine MIBI SPECT in this particular population. (CHEST 1998; 114:1097‐1104)
Fine particulate matter ambient air pollution and cardiovascular disease

This dissertation sought to examine the effect of exposure to fine particulate matter ambient air pollution (PM2.5) on cardiovascular disease and biological pathways linking them. In the first manuscript, PM2.5 air pollution was significantly associated with IHD and PVD mortality in Allegheny County, PA at a lag of 5 days, for the period 1999-2011. The risk of IHD mortality due to PM2.5 was significantly greater for individuals who died outside of a hospital or nursing home compared to deaths in the hospital or nursing home. In the second manuscript, overall, there were no appreciable effects of short and long-term exposure to PM2.5 air pollution with regard to biomarkers of cardiovascular risk i.e. CRP, WBC count, homocysteine and fibrinogen, after adjusting for demographic and cardiovascular risk factors in adult NHANES participants for the period 2001-2008. However, we did find some evidence suggesting stronger associations of PM2.5 with biomarkers of cardiovascular risk in participants with elements of metabolic syndrome e.g., obesity, diabetes, hypertension and smokers. In the third manuscript, individuals with preexisting metabolic syndrome compared to individuals without preexisting metabolic syndrome, showed a stronger positive response in systemic inflammation, as manifested by CRP and WBC count, in association with PM2.5 air pollution (both short term and long term), after adjusting for demographic and cardiovascular risk factors in adult NHANES participants for the period 2001-2008 Further research is warranted to confirm these findings in large cohorts. With one third of the U.S. population compromised by metabolic syndrome, the health impact of particulate air pollution in this sensitive population is likely to be significant and emphasizes the public health importance of this body of work.
CURRENT SUBSTANCE USE AMONGPSYCHIATRIC PATIENTS

Background-Little is known about the relationship between substance use and the onset of psychiatric disorders, and studies examining this relationship have been inconclusive. The goal of the current study was to present and discuss data concerning substance use among patients with mental disorders in Iran. Methods-A sample of 205 psychiatric patients (70 women, 135 men; mean age, 35 years [SD = 10.4, range, 16–69]). was randomly chosen. The subjects, who had schizophrenia or mood disorders, were evaluated by interview using a confidential questionnaire. Results-Of the participants, 76% of the men and 34% of the women admitted to substance use at any time: cigarettes (men 74%, women 31.4%), opioids (men 31.9%, women 4.3%), alcohol (men 23.7%, women 3.4%), hashish (men 8.9%, women 0%), marijuana (men 3.7%, women 0%), and cocaine or LSD (0%). Only 27% of the women and 63% of the men reported still using a substance regularly (some reported using more than one). Of those, 61.8% of the schizophrenics, 20% of those with unipolar depression, and 37.5% of bipolar patients reported current use. The reasons for substance use in order of frequency were, for men: 1) release of tension; 2) pleasure seeking; and 3) need (to avoid withdrawal symptoms). For women, they were: 1) habit; 2) pleasure seeking; and 3) need. Conclusion-Substance use should be a major focus of risk assessment for psychiatric settings. These findings can be considered for therapeutic and preventive programs for substance users among psychiatric patients.