Miracle-dz/UniFAR-FTUs huggingface dataset:
Mental Health and Substance Use: A Qualitative Study of Resident Assistants' Attitudes and Referral Practices

This study described mental health and substance use referral practices of resident assistants (RAs). Interviews were conducted with 48 RAs at three campuses. RAs generally had positive attitudes toward helping residents, and believed that existing norms supported their referral actions. However, many perceived referring residents to be emotionally burdensome, and they were not confident referrals would lead to positive outcomes. RAs reported referring residents for professional assistance only when problems were judged to be severe, essentially engaging in a form of clinical evaluation to make referral decisions. Recommendations for enhancing the continuum of care provided to distressed residents are discussed.
Status of haemorrhagic septicaemia based on epidemiology in Pakistan.

Haemorrhagic septicaemia (HS) was recorded by prevalence and importance percentages in Pakistan using various procedures of Participatory Disease Surveillance. The data obtained were analyzed to identify the high risk and low risk areas for HS in Pakistan. The highest prevalence (49.00%) was recorded in Khanewal district, while lowest (0.78%) was recorded in Jamshaid Saddar (Karachi). Highest importance (75.64%) was recorded in Faisalabad district, while lowest (1.53%) was recorded in Bajaur agency.
Phase II Study of Irinotecan, High-dose 5-fluorouracil, and Leucovorin Combination Chemotherapy in Taxane and Cisplatin-based Chemotherapy-refractory Metastatic Gastric Cancer

This phase II study evaluated the efficacy and safety of combination chemotherapy with irinotecan, highdose 5-fluorouracil (5-FU), and leucovorin as a second line of treatment in metastatic gastric cancer refractory to taxane and cisplatin-based chemotherapy. Eligible criteria were as follows: histologically confirmed adenocarcinoma of the stomach previously treated with taxane and cisplatin, age≥18 years, Eastern Clinical Oncology Group (ECOG) performance status of 1 or less, and adequate organ function. Irinotecan (150 mg/m 2 ) and leucovorin (200 mg/m 2 ) were given on day 1, followed by a 400-mg/m 2 bolus infusion of 5-FU and then 2,400 mg/m 2 5-FU as a 48-hour continuous infusion. This cycle was repeated every 2 weeks until disease progression or unacceptable toxicities. Thirty-seven patients were enrolled. The patients’ median age was 55 years (range, 27∼73 years), and the ECOG performance status of all patients was 1. All patients were evaluable for safety and survival, and 29 patients (78.3%) were evaluable for tumor response. The overall response rate was 17.2% [95% confidence interval (CI): 3.5∼30.9%]. The median progression-free survival and overall survival were 4.3 months (95% CI: 2.1∼6.6) and 10.6 months (95% CI: 7.1∼14.1). Greater than grade 3 hematological toxicities were neutropenia in 9 (24.3%), febrile neutropenia in 1 (2.7%), and thrombocytopenia in 1 (2.7%) patient. The major nonhematological toxicity was asthenia, but most patients showed grade 1 or 2. Greater than grade 3 nonhematological toxicities were elevated AST/ALT in 4 (10.8%), hyperbilirubinemia in 2 (5.4%), and nausea in 2 (5.4%) patients. This study showed that combination chemotherapy with irinotecan, high dose 5-FU, and leucovorin is well tolerated and active in patients with cancer refractory to taxane and cisplatin.
Physiological responses to submaximal exercise at the mid‐follicular, ovulatory and mid‐luteal phases of the menstrual cycle

This study examined the responses of eumenorrheic women to 60 min of submaximal exercise at the mid‐follicular (MF), ovulatory (OV) and mid‐luteal (ML) phases of the menstrual cycle. Blood metabolite‐hormonal measures, cardiorespiratory responses and ratings of perceived exertion (WE) (local, legs only; and total, entire body) were monitored at 15‐min intervals throughout exercise. No significant effects for phase were observed in the blood measures or the cardiorespiratory responses, except for the respiratory exchange ratio (RER). The overall exercise OV RER (0.86 ± 0.02; mean ± SEM) was lower than at MF (0.94 ± 0.02) but not at ML (0.89 ± 0.01). Substrate utilization (%) and oxidation (g/min) calculations indicated that more fat was used during OV than at MF but not ML. Conversely, more carbohydrate was used during MF than OV. Additionally, local RPE was higher in OV than in the MF or ML trials at 30–60 min of exercise. These findings suggest that menstrual cycle hormonal fluctuations influence metabolic substrate usage and effort perception during submaximal exercise in eumenorrheic women.
Extraction and biomedical application of peripheral blood stem cells in sheep and horses

ii UITTREKSEL v DEDICATION viii ACKNOWLEDGEMENTS ix LIST OF TABLES xvii LIST OF FIGURES xix LIST OF ABBREVIATIONS xxxii CHAPTER 1: Adult Stem Cells in Equine Tendon Repair: Status Quo? 1 1.1 TENDON INJURY AS A COMMON OCCURRENCE IN THE EQUINE INDUSTRY 1 1.2 TENDON INJURY 3 1.3 SOME CONVENTIONAL TREATMENTS PROMOTING TENDON REPAIR 4 1.3. 1 Anti-inflammatory drugs 5 1.3. 2 Intralesional pharmacological therapy 6 1.3. 3 Low level cold laser therapy and electromagnetic field therapy 7 1.3. 4 Extracorporeal shock wave therapy 7 1.3. 5 Surgical tendon splitting/desmoplasty 8 1.3. 6 Tissue engineering, autologous and allogeneic transplants and/or grafts . 8 1.3. 7 Tenocyte cell therapy 10 1.4 STEM CELL APPLICATION AS POTENTIAL NEW THERAPEUTIC METHOD 10 1.5 ESTABLISHING A VIABLE SOURCE OF STEM CELLS 13 1.6 COMMERCIAL VENTURES PROMOTING THE THERAPEUTIC USE OF STEM CELLS IN TENDON REPAIR 18 1.7 PREVENTION BETTER THAN CURE? 19 1.8 CONCLUSION AND CAUTIONARY REMARKS 19 1.9 STUDY OBJECTIVES 21
Systemic Analysis of Sudden Natural Deaths at Braithwaite Memorial Specialist Hospital Port Harcourt, Nigeria

Background: Many cases of sudden unexpected natural deaths occur in individuals without known medical diseases. Relatives of such victims and the law enforcement agents often designate those as sudden and unnatural deaths (SUD), and call for coroners inquests. Aims: To analyze the anatomic causes of sudden natural deaths investigated by the Coroner at Braithwaite Memorial Specialist Hospital (BMSH), and to classify them according to body systems and compare our findings with those of previous studies. Materials and methods: This is a nine-year retrospective study carried out in BMSH Port Harcourt, Nigeria. The reports of unlimited and standardized autopsies carried out on sudden and natural death victims were retrieved and analyzed. The causes of death were grouped according to the body systems involved. The cases were also analyzed according to age, sex, and circumstances of death. Results: Of the 9,164 bodies received, 2,415 (26.4%) were autopsied for varied reasons, out of which 249 (2.7%) were sudden natural deaths in persons without known significant medical history. Male: female ratio (MFR) was 2.2:1. The mean age was 39.7 years with a range of 3 weeks to 97 years. Peak age group was 30-39 years with 27.7%. Cardiovascular system pathologies were by far the commonest causes of death with 87.6%. The least cause of death was prematurity with 0.4%. Among the cardiovascular system pathologies, hypertensive heart disease was the commonest. All deathswere from natural causes. Conclusion: Cardiovascular system pathologies especially hypertensive heart disease remain the leading cause of sudden natural deaths in this study. Residents of Rivers state of Nigeria should be more conscious of their health and undergo regular medical check-ups for early detection and proper management of cardiovascular diseases especially systemic hypertension. Key Words: Sudden natural deaths, autopsy, coroner, hypertension, Port Harcourt.
Toxicity of Oral Agents Used to Treat Diabetes

Oral agents used for the management of type 2 diabetes mellitus include sulfonylureas, biguanides, thiazolidinediones, metglitinides, and/or α-glucosidase inhibitors. These medication classes can be further classified as hypoglycemic and antihyperglycemic agents. Hypoglycemia is a major symptom of toxicity of these agents, particularly with the sulfonylureas, including combination medications that include sulfonylureas. In overdose situations, metformin, a biguanide, can lead to considerable gastrointestinal adverse effects and potentially lactic acidosis in severe cases. Data on the management of toxicities of the other classes are limited. This article will review the treatment modalities that have been used for treating symptomatic hypoglycemia and metformin-induced lactic acidosis.
The attitudes of student nurses toward clinical work

Clinical work in nursing education is an important component of the nursing curriculum aimed at actively engaging student nurses with the necessary skills needed for the nursing profession. The attitude of nursing students toward clinical work is becoming a topic of interest for nursing researchers. The objectives of the study were to determine the perspective of practicing nurses on students’ attitude toward clinical work. Structured and semi-structured questionnaires were administered to determine the attitude of nursing students towards clinical work from the perspective of 100 practicing nurses from Agogo Presbyterian Hospital. The results indicated that 63% of the respondents said nursing students reported late to work, 60% reported that students were absent from clinical work without seeking permission, and 64% reported they used mobile phones during clinical working hours. In addition, 41% of the respondents stated that the nursing students did not show commitment to clinical work. Also, the attitude portrayed by students had an influence on the way the medical and nursing staffs related to them. It is recommended that students should receive in-service training before going to the clinical area, so that they are aware of what is expected of them during clinical placement. Also, systems should be put in place to ensure that nursing students do not use mobile phones in the clinical environment. There should be preceptors in the ward to monitor and mentor student nurses. The nursing schools should periodically follow-up with practicing nurses, to assess the behaviors and attitudes of the nursing students. Key words: Student nurse’s attitude, clinical work, nurse’s perception.
Prevalence of smokeless tobacco use among school going adolescent students of Raipur city Chhattisgarh state, India

Background: Tobacco consumption in various forms in recent years is a proven risk factor and contributes substantially to the emerging epidemic. Increasing tobacco use and its impact on physical and psychosocial health is a worldwide public health concern affecting the early youth and whole life of the individuals. Tobacco is used in different forms and health effects are seen irrespective of the form in which it is used. Smokeless tobacco is found to be as addictive and harmful as smoking. Objectives: To assess the prevalence and factors influencing smokeless consumption among high school students in Raipur city. Methods: Study design: Cross-sectional, Study area: 16 selected high schools of Raipur city, in which 12 were government schools and 4 private schools. Study subjects: 1006 high-school students, Sampling technique: Two stage cluster sampling according to probability proportional to size, Study tool: Predesigned pretested questionnaire. Statistical analysis: Data was entered in Microsoft excel sheet and analyzed in Epi info 7 software. Results: The mean age of students in the study was 15 years. The prevalence of smokeless tobacco consumption was 10%. Majority male 80.9% were users, mean age of initiation was 13 years (SD 7.07), Peer pressure (76%) was the reason for initiation. Pocket money 57.1% found to be the major source of purchasing. Strong association of family member tobacco use and promotional advertisement were found. Conclusion: Study reflects smokeless tobacco use was prevalent among adolescent students and there is a need for targeted interventions to reduce the risk and deleterious consequences.
Monitoring health‐care processes: a framework for performance indicators

Until recently, it was uncommon to ask professionals to give objective evidence to non‐professionals regarding the quality of their work. Nowadays, however, professionals, their health‐care processes and their health‐care organisations have to face assessments concerning organisation, control and content of the work. Meanwhile, health‐care organisations generate improvement programmes to mutually match activities of individual professionals and to redesign health‐care processes within or between health‐care organisations. In all these situations information is required on the current and sometimes the improved stage of the health‐care process. Often performance indicators are mentioned to generate this information. In this paper we present a framework of performance indicators and related measuring instruments to monitor and evaluate health‐care processes. It is based on a literature scan and on empirical research in two general hospitals and one mental hospital. The literature scan was guided by the three case studies and in the case studies the framework was tested.
Expression of M2-Polarized Macrophages is Associated with Poor Prognosis for Advanced Epithelial Ovarian Cancer

Macrophages are polarized into two functionally distinct forms, M1 and M2, in response to different microenvironment. Tumor-associated macrophages (TAMs) generally have M2 phenotype and promote tumor progression. Few studies to date have described the infiltration of M2-polarized macrophages in ovarian cancer. We used two macrophages markers, CD68 and CD163, to analyze the expression of TAMs and to clarify the relationship between the M2 form and survival in advanced ovarian cancer. Clinical data of 110 patients with stages III-IV epithelial ovarian cancer at Sun Yat-sen University Cancer Center between 1999 and 2007 were retrospectively reviewed. Immunohistochemical staining of CD68 and CD163 was performed. Correlations between macrophage density and patient survival were analyzed. Our data showed that no significant difference was observed in survival between patients in the high- and the low-CD68 expression groups. In contrast, the progression-free survival (PFS) rates (p = 0.003) and overall survival (OS) rates (p = 0.004) were significantly higher in the low-CD163 expression group than in the high-CD163 expression group, respectively. Similarly, we also observed significantly improved 3-year PFS (49.8% vs. 11.0%, p < 0.001) and OS (77.4% vs. 45.0%, p < 0.001) rates in patients in the low-CD163/CD68 ratio group when compared with the high-CD163/CD68 ratio group. Multivariate analysis identified the density of CD163-positive cells as well as the ratio of CD163/CD68 as negative predictors for PFS and OS, respectively. Our results show that the infiltration of CD163-positive M2 macrophages as well as activation of macrophages towards the M2 phenotype may contribute to poor survival in advanced ovarian cancer.
Isolation and Identification of Renal Cell Carcinoma-Derived Peptides Associated with GP96

We determined the possible associated determinants and analyzed whether gp96-associated antigenic peptides can be found in renal cell carcinoma (RCC). The gp96-peptide complexes were chromatographically purified from resected tumor tissue of RCC patients. SDS-PAGE and Western blot analysis confirmed gp96 using the gp96 monoclonal antibody, and its concentration was measured using BCA. Approximately 20 to 50 μg gp96-peptide complexes was obtained from 1 g RCC tissue. The mass spectrometry (MS) analysis of the eluted peptides included the initial profiling using matrix-assisted laser desorption/ionization time-of-flight MS. Quadrupole time-of-flight MS combined with the Mascot search engine was used to identify the peptides and find proteins from primary sequence databases. MS analysis results demonstrated that the mass range of peptide associated with gp96 was from 1046.48 to 3501.56 Da. Further research confirmed the sequences of two gp96-associated peptides, namely, LVPLEGWGGNVM and PPVYYVPYVVL. However, the original protein of the two peptides could not be found. The results demonstrated that the gp96-associated peptides are small molecular peptides, and the two peptides are deduced to be RCC-associated peptides. The identified peptides were confirmed to be associated with gp96 using the protocols described above. However, the specificity and relevance of the association to the immunogenicity of gp96 remains to be examined. Further analysis must be accomplished before the findings can be applied in peptide vaccine.
Is obesity a predictor of high blood pressure in children and adolescents

Obesity produces, among several negative consequences on health, increases in systolic and diastolic blood pressure. Currently, the heterogeneity of epidemiological studies does not permit us to conclude that high blood pressure (HBP) is increasing as a response to the obesity epidemic. However, when blood pressure (BP) is compared between non-obese and obese children or adolescents, both levels and prevalence of HBP are higher in obese individuals. Furthermore, it has been observed that changes in BMI directly alter BP: if the BMI increases, so too does BP, especially when this occurs in the first years of life or when the previous BMI was in the lowest deciles. Nevertheless, if BMI decreases, BP remains close to normal levels. Having obesity at any age is associated with an increased risk of experiencing HBP (OR: 1.5–4.4). The trends in BP in levels and prevalence are inconsistent among countries; however, with the obesity epidemic, it is possible to expect an upward trend, especially in systolic HBP. T.
Gingival contour assessment: clinical parameters useful for esthetic diagnosis and treatment.

BACKGROUND The purposes of this study were to quantify some clinical parameters that are useful as esthetic guidelines when the gingival contour is modified and to compare the left and right sides of the six maxillary anterior teeth. METHODS Maxillary casts mounted on an articulator according to the axis orbital plane were photographed from 103 young adults. The angle formed between the gingival line and the maxillary midline (GLA) and the distance between the gingival zenith of the lateral incisor and the gingival line (LID) were measured. The asymmetry was evaluated using a paired t test for the left versus right measurements of GLA and LID. The descriptive statistics for GLA and LID were calculated. RESULTS The GLA measurements of the left side (86.5 degrees +/- 5.1 degrees ) were significantly greater than those of the right side (85.2 degrees +/- 4.9 degrees ), and the mean absolute asymmetry for GLA was 4.1 degrees +/- 3.0 degrees . The mean LID measurement was 0.68 +/- 0.52 mm. CONCLUSIONS The gingival zenith of the canine is apical to the gingival zenith of the incisors (GLA <90 degrees ), and the gingival zenith of the lateral incisor is below (81.1%) or on (15%) the gingival line when the head is oriented in the axis orbital plane. A directional asymmetry was shown, with the right side higher than the left side. Along with other parameters related to dental esthetics, these clinical parameters applied to the gingival contours may serve as esthetic guidelines and may enable us to obtain a more predictable esthetic outcome.
Cardiotonic steroids: novel mechanisms of Na+i-mediated and –independent signaling involved in the regulation of gene expression, proliferation and cell death

Vascular remodeling and hypertrophy/hyperplasia of the heart and kidney are known to be major servomechanisms of long-term maintenance of elevated blood pressure and the development of cardiovascular and renal complications seen in hypertension. Several lines of evidence suggest that these abnormalities are genetically determined and evoke an imbalance between cell proliferation and death. During the last 2 decades, it was shown that the level of cardiotonic steroids (CTS), i.e. potent and selective Na+,K+-ATPase inhibitors, is increased in several forms of volumeexpanded hypertension. We focus our review on recent data implicating CTS in the regulation of cell proliferation and death. At low concentrations, CTS augment proliferation of vascular smooth muscle cells (VSMC) as well as renal epithelial and vascular endothelial cells without significant inhibition of Na+,K+-ATPase-mediated ion fluxes. In contrast to cell proliferation, effect of CTS on cell survival is tissue-specific. In VSMC, CTS inhibit programmed cell death via a novel Na+ i-mediated, Ca2+ i-independent mechanism of expression of antiapoptotic genes including mortalin, whereas in vascular endothelial and renal epithelial cells, long-term exposure to CTS leads to cell death showing combined markers of apoptosis and necrosis. This mode of cell death is caused by interaction of CTS with Na+,K+-ATPase but is independent of inhibition of the Na+,K+-ATPase-mediated ion fluxes and inversion of the [Na+]i/[K+]i ratio. We propose that these novel signaling pathways triggered by enhanced production of endogenous CTS and/or abnormal Na+ handling contribute to cardiovascular and renal complications seen in hypertension.
Health Literacy and Socioeconomic Characteristics among Older People in Transitional Kosovo

Aims: Health literacy among older people has received little attention in transitional countries of Southeast Europe. Our aim was to assess the level and socioeconomic correlates of health literacy among older people in Kosovo, a post-war country in the Western Balkans. Study Design: Cross-sectional study. Place and Duration of Study: Kosovo, between January-March 2011. Methods: This nationwide survey, conducted in Kosovo in 2011, included 1753 individuals aged ≥65 years (886 men, 867 women; mean age 73.4±6.3 years; response rate: 77%). Participants were asked to assess, on a scale from 1 to 5, their level of difficulty with regard to access , understanding , appraisal , and application of health information. Subscale scores and an overall health literacy score were calculated for each participant. Information on socioeconomic characteristics was also collected. Results: Subscale scores of health literacy were strongly correlated with each-other
Randomized, placebo-controlled trial of HA-1A, a human monoclonal antibody to endotoxin, in children with meningococcal septic shock. European Pediatric Meningococcal Septic Shock Trial Study Group.

Meningococcal septic shock has a rapid onset and characteristic skin hemorrhages that allow bedside diagnosis. Initial plasma endotoxin levels are high and correlate closely with clinical outcome. In a double-blind, randomized, placebo-controlled trial (planned, n = 270; actual, n = 269), we compared the effectiveness of HA-1A (6 mg/kg of body weight iv; maximum, 100 mg), a human monoclonal antibody to endotoxin, and placebo in reducing the 28-day all-cause mortality rate among children with a presumptive clinical diagnosis of meningococcal septic shock. Treatment groups were well balanced for baseline characteristics and prespecified prognostic variables. In this trial no significant benefit of HA-1A could be demonstrated. The 28-day mortality rates in the intention-to-treat analysis were as follows: placebo, 28%; HA-1A, 18%; reduction in mortality, 33% (P = .11, per Fisher's exact test, two-tailed; odds ratio = 0.59; 95% confidence interval for the difference, 0.31-1.05). All patients tolerated HA-1A well, and no antibodies to HA-1A were detected.