Miracle-dz/UniFAR-FTUs huggingface dataset:
Molecular surveillance of antimicrobial resistance and transmission pattern of Mycobacterium leprae in Chinese leprosy patients

ABSTRACT Reports on antimicrobial resistance (AMR) of Mycobacterium leprae, relationship with bacteriological index (BI), and transmission in China are limited. We investigated the emergence of AMR mutations, the relationship between BI and AMR in complete, moderate and lack of BI decline cases, and molecular epidemiological features of AMR cases by enrolling 290 leprosy cases from four endemic provinces. Seven (2.41%), one (0.34%), five (1.72%), one (0.34%), and one (0.34%) strains had single mutations in folP1, rpoC, gyrA, gyrB, and 23S rRNA, respectively. Double mutations in folP1 and gyrA, rpoB and gyrA, and gyrA and 23S rRNA were observed in one (0.34%) strain each. Mutated strains occurred in three out of 81 (95% CI−0.005-0.079, p = 0.083) cases with complete BI decline, in seven out of 103 (95% CI 0.018-0.117, p = 0.008) cases with moderate BI decline, and in four out of 34 (95% CI 0.003-0.231, p = 0.044) cases with lack of BI decline. Most of these mutated strains were geographically separated and diverged genotypically. AMR mutations may not be the main cause of the lack of BI decline. The low transmission of AMR strains at the county level indicates an ongoing transmission at close contact levels.
Increasing Oxygen Uptake in Well-Trained Cross-Country Skiers During Work Intervals With a Fast Start.

PURPOSE Accumulated time at a high percentage of peak oxygen consumption (VO2peak) is important for improving performance in endurance athletes. The present study compared the acute effect of a roller-ski skating session containing work intervals with a fast start followed by decreasing speed (DEC) with a traditional session where the work intervals had a constant speed (similar to the mean speed of DEC; TRAD) on physiological responses, rating of perceived exertion, and leg press peak power. METHODS A total of 11 well-trained cross-country skiers performed DEC and TRAD in a randomized order (5 × 5-min work intervals, 3-min relief). Each 5-minute work interval in the DEC protocol started with 1.5 minutes at 100% of maximal aerobic speed followed by 3.5 minutes at 85% of maximal aerobic speed, whereas the TRAD protocol had a constant speed at 90% of maximal aerobic speed. RESULTS DEC induced a higher VO2 than TRAD, measured as both peak and average of all work intervals during the session (98.2% [2.1%] vs 95.4% [3.1%] VO2peak, respectively, and 87.6% [1.9%] vs 86.1% [3.2%] VO2peak, respectively) with a lower mean rating of perceived exertion after DEC than TRAD (16.1 [1.0] vs 16.5 [0.7], respectively) (all P < .05). There were no differences between sessions for mean heart rate, blood lactate concentration, or leg press peak power. CONCLUSION DEC induced a higher mean VO2 and a lower rating of perceived exertion than TRAD, despite similar mean speed, indicating that DEC can be a good strategy for interval sessions aiming to accumulate more time at a high percentage of VO2peak.
Relationship Between Respiratory Muscle Strength, Handgrip Strength, and Muscle Mass in Hospitalized Patients.

BACKGROUND Minimal information is available to validate measurement of respiratory muscle strength (RMS) in the clinical setting. The purpose of this study was to determine the correlation between maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and sniff nasal inspiratory pressure (SNIP) with handgrip strength (HGS) and cross sectional muscle area obtained via diagnostic abdominal computed tomography (CT). MATERIALS AND METHODS Measures of MIP, MEP, SNIP, and HGS were obtained from individuals that participated in a previously published study; individuals who had an abdominal CT completed with (±)7 days of obtaining RMS measures were included. Both RMS and HGS were measured within 48-72 hours of admission; for RMS, the highest absolute (cm H2 O) and percent predicted values were recorded, and the average of 3 HGS measurements (kg) was documented. Cross-sectional muscle area (cm2 ) at the third lumbar region was recorded. Spearman's correlation coefficient was used to assess the relationship between variables. RESULTS A total of 35 participants were included. HGS was correlated to absolute MIP (rs = 0.62, rs = 0.61), MEP (rs = 0.74, rs = 0.73), and SNIP (rs = 0.58, rs = 0.54) for males and females, respectively. Crosss-sectional muscle area was correlated with absolute MIP (rs = 0.66), MEP (rs = 0.58), and SNIP (rs = 0.783) for men and absolute SNIP (rs = 0.56) among women. CONCLUSION Measures of RMS represent a promising assessment of muscle mass and function among hospitalized patients.
Obstacles to Recovery from Musculoskeletal Disorders in Industry

The burden of musculoskeletal disorders on society is substantial, requiring effective management especially in an occupational context. Occupational health guidelines recommend addressing potentially detrimental psychosocial factors in the management of workers sick-listed with musculoskeletal disorders, yet the specific influence on absence from occupational and clinical psychosocial risk factors (termed 'blue' and 'yellow' flags) remains under-explored. A four-year study was carried out in two phases: (1) a workforce survey of a large multi-site company in the UK, (2) a controlled trial of an occupational guidelines-based intervention protocol for workers with musculoskeletal disorders, focusing on obstacles to recovery/return-to-work. The results confirmed a general association between the psychosocial work environment and musculoskeletal disorders. Prospectively, psychosocial risk factors predicted the likelihood of future absence, but not its duration; routine psychosocial screening to predict return-to-work time may have limited value. Implementation of an early proactive occupational health protocol (psychosocial intervention and a supportive network with all players onside) was a successful strategy for reducing absence due to musculoskeletal disorders, for both return-to-work time and future workloss. The effect was observed at both the site level and the individual level. Organisational obstacles (black flags) were identified, which compromised the experimental intervention. It remains to be determined which, if any, specific components of the intervention package might be most effective
Retrograde Intubation in Temporomandibular Joint Ankylosis-A Double Guide Wire Technique

Intubating a patient with temporomandibular joint ankylosis is always a challenge particularly when fibreoptic laryngo­scope is not available. In a 20-year-old male patient we successfully carried out endotracheal intubation with 7 mm portex cuffed PVC tube with the help of two flexible J tipped guide wires. One guide wire was passed into the airway from cricothyroid puncture site and another from subcricoid site. Both were brought out through the nose. The first guide wire was used for retracting the epiglottis and the second as a guide for passing the endotracheal tube.
Avaliação do conhecimento e hábitos de fotoproteção entre crianças e seus cuidadores na cidade de Porto Alegre, Brasil

Introduction: Childhood is considered a critical period for photoprotection, since approximately 80% of the exposure to the sun occurs during this phase of life. Objectives: To evaluate the characteristics of the knowledge and sun protection habits of children and their caregivers. Methods: A cross sectional study was conducted with questionnaires from October 2011 to July 2012. Results: 177 children (mean age = 7.66 years); 64.9% of children assessed exposure to the sun as dangerous, 88.7% knew what sunscreen is, and 94.3% considered its use important; however, 66.6% believed it was necessary only in summer. Regarding photoprotection habits, 37.3% reported exposure to the sun between 10a.m. and 4p.m. Among caregivers, 81.3% reported an absence of daily application of sunscreen on their children, and 33.9% reported that their children had already had some type of sunburn. Conclusions: Strong dissociation between knowledge and practice regarding exposure to the sun was observed in the present study. The discrepancy between knowledge and habits that was observed in the two groups can be explained by the quality of information on exposure to the sun. The present study’s data point to the need for a wider dissemination of adequate knowledge, both by the media and by physicians, to nurture healthy practices regarding exposure to the sun
Evaluación bioquímica de la fenilcetonuria (PKU): del diagnóstico al tratamiento

Non treated phenylketonuria (PKU) has serious consequences such as growth retardation and intellectual impairment along with symptoms like erythematous eczema, fair skin and hair, seizures, autistic conduct and aggressive behavior. Pre-symptomatic biochemical diagnosis consists of identifying patients by blood phenylalanine (Phe) quantification through newborn screening. The confirmation is based on determining serum Phe and tyrosine levels. There is a wide spectrum of hyperphenylalaninemia clinical presentation, which ranges from mild forms which do not require nutritional treatment to the most severe form of the disease known as classic PKU. The aim of treatment is to avoid irreversible neurological impairment by stabilizing blood Phe level and keeping it within therapeutic concentration range. Once PKU diagnosis has been established, there are several criteria to decide when it is necessary to initiate treatment, we start it if Phe level is > 360 micromol/L (6 mg/L). Besides periodical Phe and Tyr testing, biochemical follow-up includes the measurement of necessary elements that guarantee normal physical and intellectual development such as selenium, zinc, B12 vitamin, folates, iron and long chain fatty acids. Clinical context is as important as biochemical status so periodic evaluation of nutritional, medical, social and psychological aspects should be included.
Indução do parto em pacientes com cesárea anterior

Quando a paciente tem uma cesarea anterior e esta indicada a interrupcao da gravidez, ha duas possibilidades de conduta: a repeticao da cesarea ou a inducao do parto. A cesarea iterativa ou a inducao do parto em pacientes com cesarea anterior apresentam riscos e beneficios. Uma complicacao rara e perigosa, relacionada a presenca de uma cicatriz uterina, e a ruptura uterina. Isso pode ocorrer antes ou durante o trabalho de parto em pacientes com cesarea anterior. Os riscos associados a uma tentativa de parto vaginal sao maiores do que aqueles decorrentes de cesarea iterativa, mas permanecem baixos. Acreditamos que, em locais adequados, a inducao do parto vaginal apos cesarea e uma opcao aceitavel para mulheres, sem apresentar contraindicacoes, e e uma conduta obstetrica recomendavel. When a woman has had a previous cesarean section and is indicated interruption of pregnancy, there are two options for her management: elective repeat cesarean or planned induction of labour. Elective repeat caesarean section and induction of labour for women with a prior caesarean are both associated with risks and benefits. One uncommon, but potentially serious complication associated with a prior uterine surgery, including a previous caesarean section, is uterine rupture. This may occur prior to the onset of labour, or during labour in patients with previous cesarean section. The risk associated with an attempted vaginal delivery is greater than the risk associated with an elective repeated cesarean, but it remains low. We believe that, in the appropriate setting, planned induction of labour after a cesarean is an acceptable option for women without other contraindications, and that vaginal birth after a cesarean remains within the standard of care.
White matter abnormalities in psychiatric disorders

Abstract This article reviews the reports of white matter abnormalities in several psychiatric disorders. Volumetric differences found by voxel-based morphometry or region-of-interest analysis of structural magnetic resonance imaging studies are described. Abnormalities in the diffusion metrics, primarily fractional anisotropy and mean diffusivity, from diffusion tensor imaging studies are also summarized. The consensus is that there are widespread abnormalities in white matter in psychiatric disorders, but no particular region has been identified as specific to any one disease. Instead, these diseases seem to impact commonly the corpus callosum and superior longitudinal fasciculus, as well as several other connecting tracts. Neuroimaging has provided significant insights into the aberrant white matter in these diseases, but more work is required to understand the timing, progression, and underlying pathophysiology of these abnormalities.
Drug-related knowledge, attitudes and beliefs in Ireland: report of a nation wide survey.

This report presents the findings of a nation-wide survey of public attitudes towards, and perceptions of, aspects of the drug issue in Ireland. The questionnaire on which the research was based constituted a module of the 1998 Irish Social Omnibus Survey. A total of 1,000 individuals, randomly selected from the 1997 Register of Electors for Ireland (26 counties), took part in the study. Data was collected using face-to-face interviews between February and April 1998. The survey found that members of the general public were generally aware of the kinds of illegal drugs most commonly used. Self-reported cannabis use (as measured by lifetime prevalence) stood at 12 per cent. The younger urban sector of society tended to have greater personal experience of cannabis, to know people who had taken cannabis or had 'a drug problem'. The results indicated a high level of concern about the current drug situation among the general public. Three quarters of the respondents were of the opinion that the current drug situation in Ireland was 'out of control'. There was concern also regarding the legal drug, alcohol. Over half of respondents (56%) considered that alcohol abuse caused more problems in society than drug abuse. A substantial proportion of respondents believed that experimentation with drugs was commonplace among young people. Respondents generally regarded illegal drug taking as a dangerous pursuit. Social avoidance and fear of drug users and those addicted to drugs were high among respondents. Moreover, sympathy for drug addicted individuals was relatively low, with over half the respondents believing that those with a drug problem had only themselves to blame. Those with personal knowledge of someone 'with a drug problem' typically held more positive attitudes towards those who were addicted to drugs. Consistent with the widespread concern about the severity of the current drug situation was an overwhelmingly high level of support for drug prevention. Current harm reduction initiatives, including the provision of heroin substitutes such as methadone, and needle exchange facilities to heroin dependent clients, received support from two thirds of respondents (63% and 66% respectively).
The Diversity and Complexity in Health Promotion and Empowerment Related to Older Hospital Patients — Exploring Nurses' Reflections

Background: In the future, health care services will be challenged by an increasing number of older hospital patients. This prompts a need to focus on and implement a health promoting approach in older people's nursing. Aim: The aim of this exploratory study was to illuminate nurses' reflections about health promotion and empowerment related to older hospital patients. Method: The study had a qualitative descriptive design. The concepts of health, health promotion and empowerment were initially introduced to nurses before participating in multistage focus group interviews. Two groups of nurses participated in three focus group interviews that were conducted by a moderator and an assistant. The interviews were tape-recorded, transcribed verbatim and analysed with qualitative content analysis. Findings: The nurses unfolded the theme «diversity and complexity marks health promotion and empowerment related to older hospital patients» as the latent content in the text. Two categories, «empowerment as balance of power — a twofold relation» and «focusing on the individual person», described the manifest content in the texts. The categories were further supported by sub-categories. Conclusion: The focus group interviews showed the ambiguity and complexity in the interpretation of the concepts — health promotion and empowerment — related to the older hospital patient. The findings also indicated that multistage focus group interviews may be a useful tool to develop nurses' reflections about their clinical practice.
Nordic Children's Foodscapes

Abstract A study of the different food messages that children encounter and their own reflections of these messages was carried out among fifty-nine children from Denmark, Finland, Norway and Sweden. The children took photos of their “foodscapes,” including school, home, shops, streets, cafés and restaurants. The themes were healthy and unhealthy food, everyday and festive food and their favorite food. The children were well aware of common understandings of healthy/unhealthy food. They labeled fruit, vegetables and fiber-rich foods as healthy and foods rich in sugar, fat and salt as unhealthy. Unhealthy eatables belonged to festive contexts, such as cozy evenings and birthday parties. The everyday food in school and at home was considered healthier, often consisting of well-composed meals including vegetables. The children's favorite foods belonged to both the healthy and unhealthy categories. The children also dealt with the contradictions between everyday healthy food and unhealthy festive food, which involved adjusting to different social and spatial contexts.
NECK LOADING IN HIGH PERFORMANCE COMBAT PILOTS DURING AERIAL COMBAT MANOEUVRES AND SPECIFIC NECK STRENGTHENING EXERCISES

Neck injuries are common in high performance combat pilots and have been attributed to high gravitational forces and the non-neutral head postures adopted during aerial combat manoeuvres. There is still little known about the pathomechanics of these injuries. Six Royal Australian Air Force Hawk pilots flew a sortie that included combinations of three +Gz levels (1, 3 and 5) and four head postures (Neutral, Turn, Extension and Check-6). Surface electromyography from neck and shoulder muscles was recorded in-flight. Three-dimensional measures of head postures adopted in-flight were estimated post-flight with respect to end-range of the cervical spine using an electromagnetic tracking device. Mean muscle activation increased significantly with both increasing +Gz and non-neutral head postures. Check-6 at +5Gz (mean activation of all muscles = 51% MVIC) elicited significantly greater muscle activation in most muscles when compared to Neutral, Extension and Turn head postures. High levels of muscle co-contraction were evident in high acceleration and non-neutral head postures. Head kinematics showed Check-6 was closest to end-range in any movement plane (86% ROM in rotation) and produced the greatest magnitude of rotation in other planes. Turn and Extension showed a large magnitude of rotation with reference to end-range in the primary plane of motion but displayed smaller rotations in other planes. High levels of neck muscle activation and co-contraction due to high +Gz, and head postures close to end range were evident in this study, suggesting the major influence of these factors to the pathomechanics of neck injuries in high performance combat pilots. * This chapter was published in Aviation, Space and Environmental Medicine. The full citation is: Netto KJ, Burnett AF. Neck muscle activation and head postures in common high performance aerial combat manoeuvres. Aviation, Space and Environmental Medicine 2006;77(10):1049-55.
Morphine use in the last six days of life of patients with HIV/AIDS at the inpatient unit of a South African hospice implementing the ICHC model

Abstract Background Seventy-five per cent of the world's HIV/AIDS population resides in Sub-Saharan Africa. South Africa, along with the rest of Sub-Saharan Africa, is experiencing an increasing disease and palliative care burden as a result of the HIV/AIDS pandemic. At present there is no cure for AIDS and access to antiretroviral treatment is limited. HIV/AIDS is the largest single cause of death in South Africa, accounting for 30% of deaths in 2000. An estimated 20 000 of the approximately 5 350 000 infected South Africans receive antiretroviral treatment. To cope with the rising need for AIDS-related health services, a comprehensive, integrated approach to health care is advocated, with a shift in focus from hospital care to home-based care. The Department of Health supports a community home-based care (ICHC) model as one of five models of care. It is based on similar principles to palliative care and was piloted at seven hospices in South Africa. This study was conducted in the inpatient unit (IPU) of a hospice participating in the ICHC pilot project. This model requires that the hospice provide the overall management of the home-based care programme, as well as various forms of support. Care provision is shared between professional nurses and non-professional community-based caregivers, who are trained by Hospice. For challenging symptoms, respite or terminal care, the hospice has a six-bed IPU to which patients can be admitted for short periods. The AIDS patients admitted to the IPU of the study hospice were all cared for under the ICHC model. Method This study was a retrospective case-control study conducted in a hospice in South Africa. Cases were consecutive deaths related to AIDS. Controls were cancer patients matched for socioeconomic status. Results Five days before their death, morphine for pain control was given to three of the 29 (10%) AIDS patients and to 20 of 29 (69%) cancer patients (p < 0.001). On the day of their death, morphine for pain control was given to 17 (59%) of the AIDS patients and 25 (86%) of the cancer patients (p < 0.05). Eleven (65%) of the 17 AIDS patients who were given morphine died within 48 hours of commencing with the treatment. The morphine starting dosages were within the lower therapeutic range. Conclusions The palliative care of dying cancer patients met internationally recognised standards. The results suggest that the pain of AIDS patients admitted to the IPU was under treated in terms of both dosage and duration. It is unlikely that the use of opiates or sedatives hastened death in dying AIDS (or cancer) patients. All the AIDS patients admitted to the IPU were cared for under the integrated community home-based care (ICHC) model. This raises the following questions: Is the ICHC model as implemented by this hospice achieving the symptom relief intended? And, is this typical of palliative care for AIDS patients in South Africa?