Miracle-dz/UniFAR-FTUs huggingface dataset:
Risk Factors for Birth Related Perineal Truama among Low Risk Parturient Women and Nursing Implications

Perineal trauma related to vaginal delivery may occur spontaneously during vaginal birth or when a surgical incision (episiotomy) is intentionally made to enlarge the diameter of the vagina outlet. The aim of the study was to determine the incidence of perineal trauma among low risk parturient women, find out the harmful and non harmful practices behind the occurrence of perineal trauma , and conducting a work shop for nurses working in labor unit about measures used to prevent perineal trauma. Subjects and methods, a cross sectional design was used. The sample included 500 parturient women admitted to labor room without obstetrical or medical complications. Data collection lasted 7 months, by using interview questionnaire, maternal assessment record, summary of labor sheet, a nd partograph. Results the incidence of perineal trauma was 43.0% ( 27.0% perineal tear & 16.0% episiotomy), 57.0% had their perineum intact (32.4% had first degree tear with no suture, and 24.6% had completely intact perineum). Women age, parity, short birth interval, previous perineal trauma were significantly associated with perineal trauma (p=0.00). There was direct proportion with increase the frequency and number of vaginal examination, applying fundal pressure during the second stage of labor, no psychological support, not done correct pushing after complete cervical dilatation, and not done panting and slow delivery of the head and the occurrence of perineal trauma. Conclusion almost three fifths of women had intact perineum "complete intact perin eum and first degree tear" and the rest were exposed to perineal tear and episiotomy. Risk factors significantly shown to be associated with perineal trauma were; previous perineal trauma and perineal management technique. Recommendation more publication and follow up for nursing protocol for the prevention of perineal trauma should be adopted based on the identified risk factors and taking into consideration the importance of perineal management techniques and avoidance of unnecessary vaginal examination and fundal pressure during the
Genetic variation facilitates seedling establishment but not population growth rate of a perennial invader.

BACKGROUND AND AIMS Assessing the demographic consequences of genetic variation is fundamental to invasion biology. However, genetic and demographic approaches are rarely combined to explore the effects of genetic variation on invasive populations in natural environments. This study combined population genetics, demographic data and a greenhouse experiment to investigate the consequences of genetic variation for the population fitness of the perennial, invasive herb Lupinus polyphyllus. METHODS Genetic and demographic data were collected from 37 L. polyphyllus populations representing different latitudes in Finland, and genetic variation was characterized based on 13 microsatellite loci. Associations between genetic variation and population size, population density, latitude and habitat were investigated. Genetic variation was then explored in relation to four fitness components (establishment, survival, growth, fecundity) measured at the population level, and the long-term population growth rate (λ). For a subset of populations genetic variation was also examined in relation to the temporal variability of λ. A further assessment was made of the role of natural selection in the observed variation of certain fitness components among populations under greenhouse conditions. KEY RESULTS It was found that genetic variation correlated positively with population size, particularly at higher latitudes, and differed among habitat types. Average seedling establishment per population increased with genetic variation in the field, but not under greenhouse conditions. Quantitative genetic divergence (Q(ST)) based on seedling establishment in the greenhouse was smaller than allelic genetic divergence (F'(ST)), indicating that unifying selection has a prominent role in this fitness component. Genetic variation was not associated with average survival, growth or fecundity measured at the population level, λ or its variability. CONCLUSIONS The study suggests that although genetic variation may facilitate plant invasions by increasing seedling establishment, it may not necessarily affect the long-term population growth rate. Therefore, established invasions may be able to grow equally well regardless of their genetic diversity.
Combination of Angiotensin II Receptor Antagonist with Calcium Channel Blocker or Diuretic as Antihypertensive Therapy for Patients with Chronic Kidney Disease

We compared treatment with an angiotensin II receptor antagonist (ARB) and a calcium channel blocker (CCB) combination and a fixed-dose ARB and thiazide diuretic in 18 chronic kidney disease (CKD) patients. A randomized crossover study was performed using a fixed-dose combination of losartan-hydrochlorothiazide or losartan combined with controlled-release nifedipine. Both systolic blood pressure (SBP) and diastolic blood pressures (DBPs) were lower during the nifedipine period than during the diuretic period. No significant difference was observed in urinary albumin excretion, but the estimated glomerular filtration rate was higher in the nifedipine than in the diuretic period. Serum uric acid and low-density lipoprotein cholesterol were higher in the diuretic than in the nifedipine period. A significantly low cardio-ankle vascular index, an index of arterial wall stiffness, was observed in the nifedipine period. A combination of ARB and a controlled-release nifedipine at 20–40 mg used showed a superior antihypertensive effect in CKD patients compared to a fixed-dose combination of losartan 50 mg-hydrochlorothiazide 12.5 mg in terms of blood control. The former combination is considered advantageous for maintaining renal function and artery wall elasticity without influencing uric acid or lipid metabolism.
LOCALIZATION OF ARYLSULPHATASE IN NEURONS 1

Abstract— Arylsulphatase activity, with 4‐methylumbelliferone sulphate as substrate, was measured by a quantitative histochemical method in individual anterior horn nerve cell bodies and adjacent neuropil of man and monkey; and in molecular and granular layers and subjacent white matter of cerebellum of monkey, rat and guinea pig. The activity was much higher in neuronal perikarya than in neuropil, and higher in the granular layer of cerebellum than in the molecular or white matter, thus resembling the distinctive distribution, reported in monkey, of three other lysosomal enzymes, β‐galactosidase, β‐glucuronidase and α‐naphthyl acid phosphatase. One exception was encountered: the white matter of guinea pig cerebellum had more arysulphatase activity than the granular layer. For comparison, other lysosomal enzymes also were measured in rat and guinea pig cerebellum; in these species, α‐naphthyl acid phosphatase distribution was found to differ from that of β‐galactosidase and arysulphatase, and from the pattern common to four lysosomal enzymes in the monkey.
Pharmacological venous thromboembolism prophylaxis in hospitalized medical patients: a meta-analysis of randomized controlled trials.

BACKGROUND There is uncertainty regarding which pharmacological agents most effectively prevent venous thromboembolism in hospitalized medical patients. We therefore performed a meta-analysis to determine this. METHODS MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from 1950, 1966, and 1800, respectively, through June 30, 2006, for randomized controlled trials that involved medical patients comparing unfractionated heparin (UFH) or low-molecular-weight heparin or heparinoid (LMWH) with a control, LMWH with UFH, or selective factor Xa inhibitors with a comparator. Study selection, validity assessment, and data abstraction were performed by 2 independent reviewers (L.W. and S.W.). Data synthesis was undertaken by 1 blinded investigator (S.J.H.). RESULTS Thirty-six studies were included. Compared with the control, UFH was associated with a reduced risk of deep venous thrombosis (DVT) (risk ratio [RR], 0.33; 95% confidence interval [CI], 0.26-0.42) and pulmonary embolism (RR, 0.64; 95% CI, 0.50-0.82), as was LMWH (RR, 0.56; 95% CI, 0.45-0.70; and RR, 0.37; 95% CI, 0.21-0.64, respectively). A UFH dosage of 5000 U 3 times daily was more effective in preventing DVT than a UFH dosage of 5000 U twice daily when compared with the control (RR, 0.27; 95% CI, 0.20-0.36; vs RR, 0.52; 95% CI, 0.28-0.96). Neither UFH nor LMWH reduced mortality. When directly compared with UFH, LMWH was associated with a lower risk of DVT (RR, 0.68; 95% CI, 0.52-0.88) and injection site hematoma (RR, 0.47; 95% CI, 0.36-0.62), but no difference was seen between the 2 agents in the risk of bleeding or thrombocytopenia. CONCLUSIONS Both UFH and LMWH reduce venous thromboembolic risk in hospitalized medical patients, but neither agent alters mortality. When directly compared, LMWH is more effective in preventing DVT.
Effect of bleaching agents on the microhardness of tooth-colored restorative materials.

STATEMENT OF PROBLEM There is no consensus concerning the effect of bleaching gels on microhardness of restorative materials. Information about the effect of whitening strips on microhardness of restorative materials is also limited. PURPOSE The purpose of this study was to evaluate the effect of a bleaching gel and a whitening strip on the microhardness of 3 tooth-colored restorative materials. MATERIAL AND METHODS Forty cylindrical specimens (6 x 2 mm) of each restorative material, including a nanohybrid composite resin (Grandio), a polyacid-modified composite resin (Dyract eXtra), and a glass-ionomer cement (Ionofil Molar AC), were prepared and stored in distilled water at 37 degrees C for 24 hours. The specimens were then polished using medium, fine, and superfine polishing disks and stored in 37 degrees C distilled water for 7 days. Specimens were divided into 4 groups (n=10). One group was selected for baseline Vickers hardness measurements (load 100 g, dwell time 20 seconds) of the top surfaces. The other 3 groups were treated for 21 days with 1 of the following: distilled water (control), bleaching gel (10% carbamide peroxide), or whitening strip (14% hydrogen peroxide). The top surfaces of the treated specimens were also subjected to the same hardness testing performed for the baseline specimens. Data were analyzed with 2-way analysis of variance and Tukey Honestly Significant Difference tests (alpha=.05). RESULTS There were no significant differences in microhardness between the test groups of each restorative material. However, significant differences in microhardness were observed among restorative materials. For all test groups, composite resin showed the highest hardness values, whereas glass-ionomer cement presented the lowest (P<.05). CONCLUSION The bleaching products used in this study did not adversely affect the microhardness of the restorative materials.
Content of Treatment Goals and Outcome of Brief Therapy

This research examined the role of type of treatment goal in eventual goal attainment and in outcome of brief psychotherapy for 19 outpatients who participated in a goal-setting program. Each of four goal categories produced positive attainment rates with no significant differences among them. Correlational analyses indicated that improvement was not limited to any specific type of goal.
Antimicrobial Potential of Leaf juice and Extracts of Moringa oleifera lam against some Human pathogenic Bacteria.

The antibacterial activity of ethanol, hot and cold water extracts of both fresh and dried leaves as well as the juice extracts of Moringa oleifera Lam. were obtained by standard disc diffusion methods against some human pathogenic bacteria; Staphylococcus aureus, Streptococcus faecalis, E. coli and Pseudomonas aeruginosa. The ethanol extracts of fresh leaves and dried leaves displayed a potential broad-spectrum activity against all the tested organisms, Staphylococcus aureus, Streptococcus spp, E. coli and Pseudomonas aeruginosa. Also, cold water extracts of fresh and dried leaves as well as hot water extracts of fresh and dried leaves inhibited the growth of the tested organisms with the exception of E. coli and Pseudomonas aeruginosa which were not inhibited by cold and hot water extract of fresh and dried leaves. The result of this study revealed that, the antibacterial activity of the extract could be enhanced if the components are purified. The plant therefore holds a promise as a potential source of new drugs for treating infections caused by these clinical pathogens.
Sickness Presenteeism: Prevalence, Attendance-Pressure Factors, and an Outline of a Model for Research

Objective: Sickness presence, that is, going to work despite judging one’s current state of health as such that sick leave should be taken, was investigated in relation to different work and background factors. Methods: The study group comprised a random sample of 3136 persons who responded to a questionnaire administered in conjunction with Statistics Sweden’s labor market survey. Logistic regressions were used in the analyses. Results: Fifty-three percent reported the presence of sickness (on more than one occasion during the preceding year). Having a health problem is a strong determinant of sickness presenteeism (odds ratio = 3.32). For any given health status, there are certain other factors (personally and work-related demands) that impact on the risk of sickness presence, such as difficulties in staff replacement, time pressure, insufficient resources, and poor personal financial situation. Conclusions: The study has identified different types of determinants of sickness presence. Under the assumption that there is a connection between high sickness presence and risk for future ill health, the results may provide assistance in the formulation of preventive measures.
Social influence, voluntariness, experience and the internet acceptance: An extension of technology acceptance model within a south-Asian country context

Purpose – It has been argued that behavioural models of technology acceptance do not serve equally across cultures. This study aims to extend technology acceptance model (TAM) to suit in a developing country context. The model attempts to identify the relationship between social norms, management support and moderating factors voluntariness and experience.Design/methodology/approach – The study used a quantitative methodology to investigate the correlational paths. A cross‐sectional survey was completed by 504 academics working in higher educational institutes of Pakistan. The data were analysed using structural equation modelling (SEM) based on partial least squares (PLS) methods.Findings – The extended model achieved acceptable fit and most of the hypothesised paths were significant. Determinant perceived usefulness was an important construct of the internet acceptance, i.e. R2=34 per cent more than behavioural intention. Moderator experience diminished the impact of usefulness on behaviour usage.Practi.
Self-reported alcohol consumption and its association with adherence and outcome of antiretroviral therapy in the Swiss HIV Cohort Study

Background Alcohol consumption leading to morbidity and mortality affects HIV-infected individuals. Here, we aimed to study self-reported alcohol consumption and to determine its association with adherence to antiretroviral therapy (ART) and HIV surrogate markers. Methods Cross-sectional data on daily alcohol consumption from August 2005 to August 2007 were analysed and categorized according to the World Health Organization definition (light, moderate or severe health risk). Multivariate logistic regression models and Pearson's χ2 statistics were used to test the influence of alcohol use on endpoints. Results Of 6,323 individuals, 52.3% consumed alcohol less than once a week in the past 6 months. Alcohol intake was deemed light in 39.9%, moderate in 5.0% and severe in 2.8%. Higher alcohol consumption was significantly associated with older age, less education, injection drug use, being in a drug maintenance programme, psychiatric treatment, hepatitis C virus coinfection and with a longer time since diagnosis of HIV. Lower alcohol consumption was found in males, non-Caucasians, individuals currently on ART and those with more ART experience. In patients on ART (n=4,519), missed doses and alcohol consumption were positively correlated (P<0.001). Severe alcohol consumers, who were pretreated with ART, were more often off treatment despite having CD4+ T-cell count <200 cells/μl; however, severe alcohol consumption per se did not delay starting ART. In treated individuals, alcohol consumption was not associated with worse HIV surrogate markers. Conclusions Higher alcohol consumption in HIV-infected individuals was associated with several psychosocial and demographic factors, non-adherence to ART and, in pre-treated individuals, being off treatment despite low CD4+ T-cell counts.
Clinical utility and accuracy of a blood glucose meter for the detection of neonatal hypoglycemia.

OBJECTIVE To determine the accuracy and reliability of a glucometer in comparison to hexokinase method in detecting neonatal hypoglycemia. DESIGN Comparative analytical study. PLACE AND DURATION OF STUDY Neonatal Unit of the Children ' Hospital, Lahore from August 2001 to February 2002. SUBJECTS AND METHODS All neonates presenting with known risk factors or suggestive clinical features were screened for hypoglycemia by using capillary blood on Accutrend alpha glucometer. Simultaneously the venous blood glucose values were done on Hitachi 902 autoanalyser by hexokinase method. A level of 40 mg/dl or less was taken as neonatal hypoglycemia. RESULTS A total of 292-paired samples were taken from 223 neonates. Hypoglycemia was detected in 112 samples (38.4%). Correlation of glucometer values with laboratory values of blood glucose levels was excellent throughout the range with coefficient of correlation (r) of 0.976 (p-value < 0.001). For blood glucose values < 40 mg/dl, r was 0.547 (p-value < 0.001). The instrument used showed a sensitivity of 98% and specificity of 93% to detect neonatal hypoglycemia (< 40 mg/dl) with a positive predictive value of 88% and negative predictive value 99%. CONCLUSION The blood glucose reflectance meter can be a useful and accurate instrument for screening and detecting neonatal hypoglycemia in symptomatic babies under stress. All low values by glucometer should be promptly analyzed and confirmed by chemical laboratory.
Permissive sites and topology of an outer membrane protein with a reporter epitope

We are developing a genetic approach to study with a single antibody the folding and topology of LamB, an integral outer membrane protein from Escherichia coli K-12. This approach consists of inserting the same reporter foreign antigenic determinant (the C3 epitope from poliovirus) at different sites of LamB so that the resulting hybrid proteins have essentially kept the in vivo biological properties of LamB and therefore its cellular location and structure; the corresponding sites are called permissive sites. A specific monoclonal antibody can then be used to examine the position of the reporter epitope with respect to the protein and the membrane. We present an improved and efficient procedure that led us to identify eight new permissive sites in LamB. These sites appear to be distributed on both sides of the membrane. At one of them (after residue 253), the C3 epitope was detected on intact bacteria, providing the first direct argument for exposure of the corresponding LamB region at the cell surface. At this site as well as at four others (after residues 183, 219, 236, and 352), the C3 epitope could be detected with the C3 monoclonal antibody at the surface of the extracted trimeric LamB-C3 hybrid proteins. We provide a number of convergent arguments showing that the hybrid proteins are not strongly distorted with respect to the wild-type protein so that the conclusions drawn are also valid for this protein. These conclusions are essentially in agreement with the proposed folding model for the LamB protein. They agree, in particular, with the idea that regions 183 and 352 are exposed to the periplasm. In addition, they suggest that region 236 is buried at the external face of the outer membrane and that region 219 is exposed to the periplasm. Including the 3 sites previously determined, 11 permissive sites are now available in LamB, including 3 at the cell surface and most probably at least 3 in the periplasm. We discuss the nature of such sites, the generalization of this approach to other proteins, and possible applications.
Complex chromosome 22 rearrangements in astrocytic tumors identified using microsatellite and chromosome 22 tile path array analysis

Many studies have reported chromosome 22 as being abnormal in astrocytic tumors. In an attempt to map precisely the abnormal region or regions that potentially harbor tumor‐suppressor genes or oncogenes, we constructed a chromosome 22 tile path array covering 82% of 22q with the use of 441 chromosome 22 clones. A 10‐Mb whole‐genome array consisting of 270 clones from all autosomes was included in the array. A total of 126 astrocytic tumors—5 diffuse astrocytomas (A), 29 anaplastic astrocytomas (AA), and 92 glioblastomas (GB)—were examined for chromosome 22 alterations both by microsatellite analysis (using 28 markers to identify allelic imbalance) and with the tile path array. The results showed that chromosome 22 alterations in astrocytic tumors could be complex. A number of tumors had a combination of deletions with and without reduplication of the retained chromosome, as well as copy number gains and amplifications. In two glioblastomas, overlapping homozygous deletions were identified that involved three genes (DEPDC5/KIAA0645, YWHAH, C22ORF24/HSN44A4A). The terminal region telomeric to the clone RP3‐398C22 appeared to be the most frequently deleted region. The estimated incidence of any chromosome 22 alteration was 5% in A, 33% in AA, and 38% in GB. This study demonstrated the advantages of combining array comparative genomic hybridization and microsatellite analysis in elucidating complex genomic rearrangements in primary human tumor tissue. Supplementary material for this article can be found on the Genes, Chromosomes and Cancer website at http://www.interscience. wiley.com/jpages/1045‐2257/suppmat/index.html. © 2005 Wiley‐Liss, Inc.
Variables affecting outcome in blunt chest trauma: flail chest vs. pulmonary contusion.

We reviewed 144 consecutive patients with flail chest and/or pulmonary contusion between 1979 and 1984. The purpose was to analyze the factors adversely affecting morbidity and mortality. There were 97 males and 47 females, with an average age of 40 years +/- 18 S.D. (range, 2-83). Seventy-five per cent of the injuries were caused by motor vehicle accidents, with the remainder due to falls (17%), cardiopulmonary resuscitation (4%), altercations (2%), or falling objects (2%). The Injury Severity Score (ISS) averaged 32 +/- 14 S.D. in all survivors versus 60 +/- 14 S.D. in those who died. Eighty-three patients (58%) required mechanical ventilation. Thirty-six patients died (25%). Isolated pulmonary contusion or flail chest had a mortality of 16% each. However, the mortality more than doubled when there was a combined pulmonary contusion and flail chest (42%). More than half of all deaths were directly attributed to central nervous system injuries with another third due to massive hemorrhage. Factors that were associated with a higher morbidity and mortality included severe associated thoracic injuries, a high ISS, the presence of shock, falls from heights, and the combination of pulmonary contusion and flail chest.