Miracle-dz/UniFAR-FTUs huggingface dataset:
Two Methods for Turning and Positioning and the Effect on Pressure Ulcer Development: A Comparison Cohort Study

PURPOSE: We evaluated 2 methods for patient positioning on the development of pressure ulcers; specifically, standard of care (SOC) using pillows versus a patient positioning system (PPS). The study also compared turning effectiveness as well as nursing resources related to patient positioning and nursing injuries. DESIGN: A nonrandomized comparison design was used for the study. SUBJECTS AND SETTING: Sixty patients from a trauma/neurointensive care unit were included in the study. Patients were randomly assigned to 1 of 2 teams per standard bed placement practices at the institution. Patients were identified for enrollment in the study if they were immobile and mechanically ventilated with anticipation of 3 days or more on mechanical ventilation. Patients were excluded if they had a preexisting pressure ulcer. METHODS: Patients were evaluated daily for the presence of pressure ulcers. Data were collected on the number of personnel required to turn patients. Once completed, the angle of the turn was measured. The occupational health database was reviewed to determine nurse injuries. RESULTS: The final sample size was 59 (SOC = 29; PPS = 30); there were no statistical differences between groups for age (P = .10), body mass index (P = .65), gender (P = .43), Braden Scale score (P = .46), or mobility score (P = .10). There was a statistically significant difference in the number of hospital-acquired pressure ulcers between turning methods (6 in the SOC group vs 1 in the PPS group; P = .042). The number of nurses needed for the SOC method was significantly higher than the PPS (P ⩽ 0.001). The average turn angle achieved using the PPS was 31.03°, while the average turn angle achieved using SOC was 22.39°. The difference in turn angle from initial turn to 1 hour after turning in the SOC group was statistically significant (P < .0001). No nurse injuries were reported for either group during the study. CONCLUSIONS: Findings suggest that assistive devices such as a PPS can be effective in achieving proper positioning of patients to prevent development of pressure ulcers.
Morphology of the human vertebral endplate

It is presumed that poor intervertebral disc cell nutrition is a contributing factor in degeneration, and is exacerbated by vertebral endplate sclerosis. Yet, quantitative relationships between endplate morphology and degeneration are unavailable. We investigated how endplate bone microstructure relates to indices of disc degeneration, such as morphologic grade, proteoglycan content, and cell density. Intervertebral core samples [n = 96, 14 subjects, L1–L5 level, ages 35–85 (64 ± 16 years), degeneration grade 1 (n = 4), grade 2 (n = 32), grade 3 (n = 44), grade 4 (n = 10), grade 5 (n = 6)] that included subchondral bone, cartilage endplate, and adjacent nucleus were harvested from human cadaveric lumbar spines. The morphology of the vertebral endplate was analyzed using µCT and the adjacent nucleus tissue was collected for biochemical and cellular analyses. Relationships between vertebral endplate morphology and adjacent disc degeneration were analyzed. Contrary to the prevailing notion, vertebral endplate porosity increased between 50% and 130% and trabecular thickness decreased by between 20% and 50% with advancing disc degeneration (p < 0.05). We also observed that nucleus cell density increased (R2 = 0.33, p < 0.05) and proteoglycan content decreased (R2 = 0.47, p < 0.05) as the endplate became more porous. Our data suggest that endplate sclerosis is not a fundamental factor contributing to disc degeneration. Rather, the opposite was observed in our samples, as the endplate became progressively more porous with age and degeneration. Since ischemic disc cell behavior is commonly associated with degenerative change, this may be related to other factors such as the quality of vertebral capillaries, as opposed to decreased permeability of intervening tissues. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 30:280–287, 2012
Lack of phototoxicity potential with delafloxacin in healthy male and female subjects: comparison to lomefloxacin

Aims : Delafloxacin is a fluoroquinolone antibiotic recently approved by the FDA for treatment of acute bacterial skin and skin structure infections (ABSSSI). Delafloxacin was assessed for phototoxicity potential compared with a known phototoxic fluoroquinolone. Methods : A Phase 1, investigator-blind, placebo/active-controlled, randomized, parallel-group study was conducted in 52 healthy male and female volunteers who received 200 or 400 mg of oral delafloxacin, 400 mg oral lomefloxacin or placebo once daily for 6 days. This study evaluated the photosensitizing potential and possible wavelength dependency of delafloxacin by comparing the response of the skin to ultraviolet A (UVA), ultraviolet B (UVB) and visible radiation prior to and during administration of delafloxacin, lomefloxacin as a positive control, or placebo. Adverse events were monitored throughout the study. Results : Forty-seven subjects completed six days of dosing, and no evidence of phototoxicity was seen with delafloxacin. Delafloxacin at 200 and 400 mg day^−1 and placebo did not demonstrate differences in percent change from baseline in minimal erythema dose at all tested wavelengths (295–430 nm) by monochromator and solar simulator. Lomefloxacin, the positive control, had statistically significant differences ( p < 0.05) at UVA wavelengths of 335 and 365 ± 30 nm 24 hours after radiation exposure (maximum response). The phototoxic index results were significantly higher for lomefloxacin at 335 nm and 365 nm compared to placebo and delafloxacin. Conclusions : 200 and 400 mg of delafloxacin administered for 6 days were well tolerated in healthy adult volunteers. Delafloxacin and placebo failed to demonstrate a phototoxic effect but lomefloxacin, the positive control, demonstrated moderate phototoxicity.
Murine tendon function is adversely affected by aggrecan accumulation due to the knockout of ADAMTS5

The present study examined the effect of ADAMTS5 (TS5) knockout on the properties of murine flexor digitorum longus (FDL) and Achilles tendons. FDL and Achilles tendons were analyzed using biomechanical testing, histology, and immunohistochemistry; further characterization of FDL tendons was conducted using transmission electron microscopy (collagen fibril ultrastructure), SDS–PAGE (collagen content and type), fluorescence‐assisted carbohydrate electrophoresis for chondroitin sulfate and hyaluronan, and Western blotting for aggrecan, versican, and decorin abundance and distribution. FDL tendons of TS5−/− mice showed a 33% larger cross‐sectional area, increased collagen fibril area fraction, and decreased material properties relative to those of wild type mice. In TS5−/− mice, aggrecan accumulated in the pericellular matrix of tendon fibroblasts. In Achilles tendons, cross‐sectional area, stress relaxation, and structural properties were similar in TS5−/− and wild type mice; however, the TS5−/− tendons exhibited a higher tensile modulus and a weakened enthesis. These results demonstrate that TS5 deficiency disturbs normal tendon collagen organization and alters biomechanical properties. Hence, the role of ADAMTS5 in tendon is to remove pericellular and interfibrillar aggrecan to maintain the molecular architecture responsible for normal tissue function. © 2011 Orthopaedic Research Society. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 30:620–626, 2012
Modulating nasal mucosal permeation using metabolic saturation and enzyme inhibition techniques

Presystemic elimination resulting from local enzymatic degradation can play a key role in limiting the bioavailability of intranasally administered drugs. The aim of this study was to evaluate the transfer of a metabolically susceptible drug across the nasal mucosa to illustrate the relative contributions of drug diffusivity and metabolic susceptibility on overall nasal mucosal permeation and to understand the effects of changes in enzymatic activity on the transfer across nasal epithelial and submucosal tissues.
A barrier to exclusive breastfeeding for WIC enrollees: limited use of exclusive breastfeeding food package for mothers.

BACKGROUND In the first 2 weeks of life, most breastfeeding mother-infant dyads in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) receive infant formula from WIC, instead of a larger food package designed for exclusively breastfeeding mothers. This study was designed to explore reasons for high rates of formula supplementation of breastfeeding newborns enrolled in WIC and the limited use of the WIC expanded food package. METHODS We conducted in-depth interviews with 29 mothers who either partially or exclusively breastfed for at least 2 months. Interviews were transcribed verbatim, analyzed, coded, and organized into 10 themes. RESULTS Participants view the WIC program in a contradictory manner. They see it as highly supportive of breastfeeding, but also as a promoter of infant formula. The expanded food package for mothers is not valued, but free supplemental formula is highly valued. Misinformation about breastfeeding pervades the healthcare system, and exclusive breastfeeding is not promoted as an important health goal. Lack of access to breast pumps, the unacceptability of pumping in the workplace, and difficulties with nursing in public all contribute to formula supplementation. CONCLUSIONS The healthcare system, the WIC program, and demands of daily life all contribute to low rates of exclusive breastfeeding in the WIC program. The available expanded food package for mothers who are exclusively breastfeeding is both disliked and underutilized, while free supplemental formula is rarely discouraged.
Erythropoietin augments bone formation in a rabbit posterolateral spinal fusion model

We tested the hypothesis that erythropoietin (EPO) enhances bone formation after posterolateral spinal fusion (PLF) in a rabbit model. Thirty‐four adult rabbits underwent posterolateral intertransverse arthrodesis at the L5–L6 level using 2.0 g autograft per side. The animals were randomly divided into two groups receiving subcutaneous daily injections of either EPO or saline for 20 days. Treatment commenced 2 days preoperatively. Hemoglobin was monitored at baseline and 2, 4, and 6 weeks after fusion surgery. After euthanasia 6 weeks postoperatively, manual palpation, radiographic, and histomorphometric examinations were performed. Bone volume of the fusion mass was estimated by CT after 6 weeks. EPO increased bone fusion volume to 3.85 ccm (3.66–4.05) compared with 3.26 ccm (2.97–3.55) in the control group (p < 0.01). EPO treatment improved vascularization of the fusion mass and increased hemoglobin levels (p < 0.01). Fusion rate tended to be higher in the EPO group based on manual palpation, CT, and radiographic examinations. For the first time EPO has shown to augment bone formation after autograft PLF in a rabbit model. Increased vascularization provides a partial explanation for the efficacy of EPO as a bone autograft enhancer. © 2011 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:1083–1088, 2012
Mesenchymal stem cell transplantation to promote bone healing

An overall decline in the availability of osteogenic precursor cells and growth factors in the bone marrow microenvironment have been associated with impaired bone formation and osteopenia in humans. The objective of the current study was to determine if transplantation of mesenchymal stromal cells (MSC) from a healthy, young donor mouse into an osteopenic recipient mouse could enhance osseointegration of a femoral implant. MSC harvested from normal young adult mice differentiated into bone forming osteoblasts when cultured on implant grade titanium surfaces ex vivo and promoted bone formation around titanium‐coated rods implanted in the femoral canal of osteopenic recipient mice. Micro computed tomographic imaging and histological analyses showed more, better quality, bone in the femur that received the MSC transplant compared with the contra‐lateral control femur that received carrier alone. These results provide pre‐clinical evidence that MSC transplantation promotes peri‐implant bone regeneration and suggest the approach could be used in a clinical setting to enhance bone regeneration and healing in patients with poor quality bone. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:1183–1189, 2012
The effectiveness of mental imagery for improving strength in an asymptomatic population

Abstract Background: Strength training is one focus for physiotherapy management to help restore function. However, conventional strength training requiring an active muscular contraction is not always possible. Mental imagery (MI) has been proposed as a viable alternative to strength training without the need for actual movement. Objective: To investigate whether MI is effective in achieving strength gains in an asymptomatic population. Methods: A systematic review of key databases was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and risk of bias assessed using Grading of Recommendations Assessment, Development and Education (GRADE). Studies were included if they were a randomised control trial (RCT), clinical control trial (CCT) or pre-post study investigating the effect of an MI protocol for improving strength in asymptomatic adult populations. Results: From 639 articles, 28 full texts were assessed and six were included for review. These studied effect of MI on strength improvements for 5th finger abductors (n = 53), quadriceps (n = 51), elbow flexors (n = 51), ankle dorsiflexors (n = 51) and plantarflexors (n = 51). Strength gains were reported in all muscle groups with the exception of elbow flexors. MI may be more effective for muscle groups with larger motor cortex representation, especially 5th finger abductors. Conclusion: The findings suggest that a course of MI can increase strength greater than a control group but less than a physical practice (PP) group within this population. The findings of this study provide promising clinical implications for use of MI for improvements or maintenance of strength within a patient group unable to actively strengthen due to pain or immobilisation.
Breastfeeding protects against type 1 diabetes mellitus: a case-sibling study.

BACKGROUND Some epidemiological studies have shown a protective effect of breastfeeding against type 1 diabetes mellitus (T1DM), whereas others have found opposite results. The role of early exposure to cow's milk protein and shorter duration of breastfeeding are still controversial. This study aimed to compare the frequency and duration of breastfeeding among siblings with and without T1DM. METHODS A case-control study was conducted at the Prof. Fernando Figueira Institute of Integral Medicine, Recife, PE, Brazil, between June 2009 and August 2010. The case patients were children with T1DM, and the controls were their unaffected sibling. The World Health Organization criteria for T1DM were used. All T1DM cases had the diagnostic criteria confirmed by checking their medical records. Data on infant feeding during the first year of life, prenatal care, gestational age, delivery, birth weight, and immunization status were collected through information provided by the mothers. RESULTS In total, 123 children with diabetes mellitus type 1 and their respective siblings were studied. There was no difference in breastfeeding rates among the two groups, but patients with diabetes had a shorter duration of breastfeeding (3.3 vs. 4.6 months, p < 0.001). The diabetic group was exposed earlier to cow's milk. After controlling for other associated variables it was shown that a longer duration of breastfeeding was associated with a protective effect against diabetes. CONCLUSIONS Our data support the proposal that a shorter breastfeeding interval may contribute to T1DM in Brazilian children.
Environmental Cues to Urgency and Leakage Episodes in Patients With Overactive Bladder Syndrome: A Pilot Study

PURPOSE: To assess the frequency with which environmental cues, which might constitute Pavlovian-conditioned stimuli, occur with urgency and leakage symptoms associated with overactive bladder syndrome (OAB). SUBJECTS AND SETTINGS: The sample group comprised 17 adults (13 women and 4 men); their median age was 74.71 years. METHODS: A semistructured interview was conducted with a convenience sample of 17 patients diagnosed with OAB. Patients were interviewed about interoceptive and environmental cues they related to instances of urinary urgency and leakage. Interviews persisted for 6.11 to 59.38 minutes (M = 21.86 minutes) and were conducted by an interviewer who was trained to administer the interview guide. RESULTS: Most respondents associated at least 1 environmental cue with urgency and leakage, respectively. A mean of 6.1 urgency-related and 4.0 leak-related environmental cues were reported. The most commonly reported environmental cues were “on my way to the bathroom” reported by 88% and “opening the front door of my home” reported by 71%. CONCLUSION: These findings support the hypothesis that Pavlovian conditioning plays a role in OAB symptoms and suggest that treatment might be enhanced by inclusion of Pavlovian extinction procedures.
COPD in non-smokers-prevalence and risk factors.

Studies on COPD have largely focused on the smoking rather than the non-smoking population. Hence we conducted the study to identify the non-smoking causes of COPD. The 450 COPD The aim of the to find out proportion of non smokers among all COPD patients, identify risk factors for COPD among non smokers and classify non-smoking COPD patients according to severity. Maximum patients (35.41%) among non smoker COPD group had more than one risk factor for COPD. Most of the patients among non smoker COPD were found to having severe to very severe disease (63.5%). 34.4% patients moderate COPD and very few patients mild COPD (3%). On comparing disease severity among non-smoker and smoker COPD patients, that of patients very severe in group in smoker vs. 29.2% in non smoker), while proportion of patients with mild to moderate disease were more in non smoker group in non smoker vs. 24% in smoker). Patients with severe disease in both groups were found to be of equal proportion (33.3% in non smoker vs. 36.7% in smoker).
New insights into fatigue and health‐related quality of life after delivery

Background. A delivery has a major impact on the health‐related quality of life (HRQoL) of the new mother, especially on fatigue. A common complication during delivery that might have a relationship with maternal morbidity is blood loss. The objectives were to investigate fatigue and HRQoL in women after vaginal delivery (VD), elective caesarean section (CS) and emergency CS, and its relationship with postpartum hemoglobin (Hb) levels during the first 6 weeks postpartum. Methods. Some 141 patients (71 after VD, 36 after elective CS and 34 after emergency CS) completed the HRQoL questionnaires MFI and EQ‐5D between 12 and 24 h after VD and 24–48 h after CS (t = 0). At 1, 3 and 6 weeks postpartum these questionnaires were repeated, together with the SF36. Results. Patients after VD had higher mean physical HRQoL scores than after CS. The average period to reach full physical recovery was 3 weeks after VD, 6 weeks after elective CS, and >6 weeks after emergency CS. Mean mental HRQoL scores of the study groups were similar or even better compared to reference values. The significant correlation between Hb level and mean physical HRQoL scores found at t = 0 had disappeared at 1 week postpartum. Conclusions. Results of this study provided insights into the natural course of fatigue and HRQoL postpartum. Important differences in fatigue and HRQoL scores were observed between the 3 modes of delivery. These HRQoL measures can be used in future clinical trials to assess the effects of interventions postpartum.
Apoptosis, senescence, and autophagy in rat nucleus pulposus cells: Implications for diabetic intervertebral disc degeneration

This research was aimed to study the mechanisms by which diabetes aggravates intervertebral disc degeneration (IDD) and to discuss the relationship between autophagy and IDD in nucleus pulposus (NP) cells. Sixteen weeks after injecting streptozotocin (STZ), the intervertebral discs (IVDs) were studied by histology, Alcian blue, 1,9‐dimethylmethylene blue (DMMB), immunohistochemistry, and RT‐PCR to explore the IDD. The apoptosis and senescence of NP cells was investigated by terminal deoxyribonucleotidyl transferase (TDT)‐mediated dUTP‐digoxigenin nick end labeling (TUNEL) assay, immunohistochemistry, and Western blot for caspase3, caspase8, caspase9, and p16lnk4A (increased in cellular senescence). The level of autophagy in NP cells was detected by Western blot, immunohistochemistry, and transmission electron microscopy (TEM). The proteoglycan and collagen II in the extracellular matrix and the aggrecan and collagen II mRNA expression in NP cells of diabetic rats were decreased compared with the control group. Diabetes increased apoptosis of NP cells and led to activations of initiators of intrinsic (caspases‐9) and extrinsic (caspase‐8) pathways as well as their common executioner (caspase‐3). Cellular senescence was increased about twofold in NP of diabetic rats. In addition, the Western blot, immunohistochemistry, and TEM demonstrated higher level of autophagy in NP cells of diabetic rats than control rats to a statistically significant extent. These findings support that diabetes induced by STZ can cause IDD by accelerating the apoptosis and senescence of NP cells excluding the overweight influence. And the results suggest that the autophagy may be a response mechanism to the change of NP cells in diabetic rats. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 692–702, 2013
Placental melatonin system is present throughout pregnancy and regulates villous trophoblast differentiation

Melatonin is highly produced in the placenta where it protects against molecular damage and cellular dysfunction arising from hypoxia/re‐oxygenation‐induced oxidative stress as observed in primary cultures of syncytiotrophoblast. However, little is known about melatonin and its receptors in the human placenta throughout pregnancy and their role in villous trophoblast development. The purpose of this study was to determine melatonin‐synthesizing enzymes, arylalkylamine N‐acetyltransferase (AANAT) and hydroxyindole O‐methyltransferase (HIOMT), and melatonin receptors (MT1 and MT2) expression throughout pregnancy as well as the role of melatonin and its receptors in villous trophoblast syncytialization. Our data show that the melatonin generating system is expressed throughout pregnancy (from week 7 to term) in placental tissues. AANAT and HIOMT show maximal expression at the 3rd trimester of pregnancy. MT1 receptor expression is maximal at the 1st trimester compared to the 2nd and 3rd trimesters, while MT2 receptor expression does not change significantly during pregnancy. Moreover, during primary villous cytotrophoblast syncytialization, MT1 receptor expression increases, while MT2 receptor expression decreases. Treatment of primary villous cytotrophoblast with an increasing concentration of melatonin (10 pm–1 mm) increases the fusion index (syncytium formation; 21% augmentation at 1 mm melatonin vs. vehicle) and β‐hCG secretion (121% augmentation at 1 mm melatonin vs. vehicle). This effect of melatonin appears to be mediated via its MT1 and MT2 receptors. In sum, melatonin machinery (synthetizing enzymes and receptors) is expressed in human placenta throughout pregnancy and promotes syncytium formation, suggesting an essential role of this indolamine in placental function and pregnancy well‐being.