Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of EMLA Cream to Decrease Venipuncture Related Pain and Anxiety in Children

Purposes: Venipuncture is one of the most painful and frequently performed invasive procedure for children by nurses. The purpose of this study was to investigate the effect of EMLA cream(eutectic mixture of local anesthetics: 2.5% lidocaine and 2.5% prilocaine) to decrease venipuncture related pain and anxiety in children. Methods: A randomized, double blinded, placebo-controlled study was conducted. Sixty children scheduled venipuncture were recruited, and randomly allocated to receive either EMLA or a placebo cream 1 hour before venipuncture. Venipuncture was carried out by one nurse investigator. Pain and anxiety was measured by parent, nurse investigator, and nurse observer. Results: Pain in the EMLA group was significantly lower than that of placebo group. However, there was no significant difference in anxiety score between the EMLA and placebo groups. Local side effect of EMLA cream were negligible. Conclusions: EMLA cream was found to be an effective local anesthetic for pediatric venipuncture pain. Further studies should continue to evaluate the facilitators and barriers of EMLA cream application in pediatric nursing practice.
Epidemiological profile of animal bite patients attending emergency department at a tertiary care health facility in a northern hilly Indian city

Background: Rabies is a highly infectious zoonotic disease with a high case fatality rate. In India, approximately 20,000 deaths among 17.4 million exposed people occur every year. The data on animal bites is scarce and unreliable due to poor surveillance and hence, the projected figures are far less from the actual numbers. The present study was conducted to describe epidemiological characteristics of animal bite patients attending casualty department at a tertiary care Government health facility in Shimla, Himachal Pradesh.Methods: It was a retrospective study based on secondary data received from animal bite register for year 2017 at casualty department of the Indira Gandhi Medical College and Hospital, Shimla, Data of 1512 patients attending the casualty department with history of animal bite was included for the study purpose.Results: About 58% of victims were males and the maximum (22.6%) animal bites were seen in 21-30 years age group. Majority (51.6%) of patients were exposed to dog bites, followed by monkey bites (42.85%) and cat bite 49 (3.2%). About 69.9% of animal bites were in the lower limbs, followed by upper limbs (22.1%), abdomen (4.4%) and head and neck region (3.6%). Maximum bites were category III bites (74.6%) followed by of category II bites (12.9%). Conclusions: Study highlights the neglected but significant picture of animal bite in the Shimla city. Timely and correct post exposure prophylaxis for the animal bite victims is necessary to prevent rabies. This should be supplemented with a robust surveillance and reporting system. With the global aim of zero rabies deaths by 2030; it is time to strengthen the anti-rabies activities at every level.
The role of cholecystokinin, fasting glucose, and ketone bodies on the pathogenesis of Alzheimer’s disease

Hypometabolism of glucose in the brain is associated with the neurodegenerative disorder, Alzheimer’s disease (AD), warranting further study of the relationship between metabolic function and structural integrity of the brain. While demyelination is observed with AD, less is known about the impact of glucose levels in combination with genetic risk factors on myelination. Ketone bodies are the brain’s alternative fuel source during periods of low fuel such as in Alzheimer’s disease (AD). Demyelination of the brain may lead to accumulations of amyloid beta plaques, associated with the disease (Bartzokis et al., 2007). Individuals with a family history (FH) or the APOE4 allele have been seen to have a predisposition for developing AD. Therefore, in efforts to achieve neuroprotection for people at-risk for developing the disease or during the prognosis of the disease, serum ketone bodies and glucose levels were studied in relation to white matter integrity in the brain from the Alzheimer’s Disease Neuroimaging Initiative. Cholecystokinin (CCK) was also examined in the cerebral spinal fluid. CCK is a satiety hormone that is highly expressed in brain regions like the hippocampus. CCK is integral for maintaining or enhancing memory, and thus may be a useful marker of cognitive and neural integrity in participants with normal cognition, mild cognitive impairment (MCI), and Alzheimer’s disease (AD). Interactions were also tested with genetic risk factors for AD, family history (FH) and apolipoprotein E ε4 (APOE4) status. Participants with FH or APOE4 allele showed increased myelin integrity as glucose levels increased when examining DTI fractional anisotropy in the fornix. Additionally, participants diagnosed with AD showed more demyelination compared to those who had mild cognitive impairment or who were cognitively normal as measured by DTI radial diffusivity in the fornix. Overall, the
Early Transcriptional Signature in Dendritic Cells and the Induction of Protective T Cell Responses Upon Immunization With VLPs Containing TLR Ligands—A Role for CCL2

Inducing T cell responses by therapeutic vaccination requires appropriate activation of antigen presenting cells (APCs). The use of virus-like particles (VLPs) containing Toll-like receptor (TLR) ligands has demonstrated remarkable potential in activating APCs and modulating the immune response both for prophylactic vaccines as well as immunotherapy. Here, we employed VLPs associated to TLR ligands as tools to modulate cytotoxic response mediated by CD8+ T cells and provide further insight in the development of T cell-based immunotherapy. We have investigated the in vivo transcriptional signature in dendritic cells (DCs) from mice immunized with VLPs containing distinct classes of nucleic acid and correlated the expression patterns with the efficiency of induced T cell responses. We identified key pathways activated in DCs that are involved in the appropriated induction of T cell responses and show evidence for the modulatory effect of CCL2 in CD8+ T cells responses. These insights shed light on immune networks that are pivotal for the induction of potent cytotoxic T cell responses and identify key genes for appropriate DC activation and subsequent modulation of the adaptive immune response.
Intimate partner violence management and referral practices of primary care workers in a selected population in Turkey

Abstract Background: Violence against women is a significant public health problem and primary care workers (PCWs) have a crucial role in managing violence against women. However, though intimate partner violence (IPV) is frequently seen in primary care, most cases remain unreported. Aims: This study aims to investigate family physicians’ (FPs’) and co-working midwifes/nurses’ (M/Ns’) explanations about their responses to women disclosing IPV and the reasons for their actions. Methods: We conducted a cross-sectional survey via a face-to-face administered questionnaire interview involving 266 PCWs in a selected area in Turkey. We questioned the reasoning behind inappropriate responses such as not examining the patient and document findings, not recording a code of violence, and not notifying the police in the case of a disclosure of IPV. Results: We surveyed 129 FPs and 137 M/Ns. We found that the disclosure of IPV in primary care is very high, but more than one-third of physicians and half of M/Ns respond inappropriately. Reasons for inappropriate response varied. The majority believed that the victim would continue to live with her batterer, making any report ineffective. Some expressed concern for the women’s and their own personal safety, citing an increase in assault cases by perpetrators in the last few years. Many indicated a lack of knowledge about management of violence cases. Conclusion: Multiple barriers challenge PCWs in helping abused women. Common behaviours, safety concerns, and a lack of knowledge seem to be the major barriers to responding appropriately to IPV. To address this issue appropriately, protective measures for both parties – PCWs and violence victims – need to be enacted and a supportive constitutional and societal organization is required. Screening and identification should lead to interventions that benefit the victims rather than harming them.
Comparing the Quality of Life in Patients with Stroke Under the Treatment with and Without Recombinant Tissue Plasminogen Activator

Background Stroke has been considered one of the most common life-threatening neurological disease and a global health problem. It causes disability in adults and ranked as the third leading causes of human mortality worldwide. Objectives The aim of this study was to compare the quality of life in patients with stroke in both treated and not-treated groups with recombinant tissue plasminogen activator (rt-PA). Methods We conducted a cohort study on 126 patients with stroke, including 42 and 84 patients treated with rt-PA and without rt-PA, respectively. We used a disease-specific questionnaire for stroke, including (SSQOL) and EQ5D. Both groups were tested for potential differences regarding socio-demographic characteristics. A multiple linear regression model was exerted to find factors that affected the different aspects of QOL of the whole samples of the patients. Results The result of this study showed a significant correlation in the intensity of stroke and patients’ quality of life between two groups of patients with stroke. In other words, the severity in the patients treated with rt-PA is less than a stroke three months after a stroke, and the desirability of living in this group is higher. The results of regression models for each subscale showed that age, sex, utility, hemisphere, and NHISSS were associated with several subscales of the SSQOL; NIHSS was significantly relevant to “language”, “mobility”, “personality” “social roles” and hemisphere damaged significantly correlated with “energy”, “thinking”,” language” (P < 0.05). The patient’s utility was significantly associated with “energy”, “family roles”, “language”, “mobility”, “mood”, “personality”, “self-care”, “social roles”, “upper extremity function”, “work productivity”, and “third severity” subscales (P < 0.05). Conclusions In this study, it was seen that there are significant differences between QOL of with rt-PA and without rt-PA, but the limitation of our study was that the results may be different in other countries and even various areas in Iran.
All-in-one: impact study of an online math game for educational purposes

The purpose of this evaluation study is to address the impact of an educational game in strengthening mathematical skills and knowledge. Within this framework, the study deals with the appropriateness of specific game elements corresponding to the success of a math game, taking 65 Austrian players and a control group of 41 players of a different game into account. While an exploratory factor analysis confirms the validity and reliability of the 30-item scale, linear regression analyses illustrate the significant positive impact of the game's flow to its success. An independent t-test as well as an ANOVA demonstrate no significant differences between genders. However, a Kruskal-Wallis test stresses that the game elements are significantly important for different age-groups. In addition, the results show that the game elements should be chosen carefully with respect to the educational objectives. This impact study supports the positive research stream referring to the high potential of games as an educational instrument in math education.
The myeloma-developing regimens using genomics (MyDRUG) master protocol.

TPS8057 Background: Multiple myeloma (MM) is the second most prevalent blood cancer, representing approximately 1% of all cancers. Although overall survival has improved in recent years due to new approved agents, the vast majority of MM patients (pts) ultimately stop responding to treatment. Moreover, about a quarter of MM pts characterized as “high risk” experience limited benefit from existing treatments. Seminal genomic sequencing research efforts, such as the MMRF CoMMpass study, have highlighted that a large number of MM cases harbor potentially actionable oncogenic molecular alterations and published reports on small numbers of cases suggest that Precision Medicine (PM) interventions clinically targeting such actionable drivers may benefit MM pts. These results suggest that PM approaches in MM are possible and should be further studied clinically. To that end, we have launched MyDRUG, a master protocol aimed at developing new myeloma regimens based on individual pt’s genomics. Methods: This study is a Phase I-II, multicenter master protocol in functional high risk MM patients (i.e patients having progressed from baseline treatment within 18 months without maintenance or 3 years on maintenance) with 1-3 prior lines of therapy. Patients are screened for actionable genomic alterations on the CLIA-grade MI-ONCOSEQ platform. Patients with actionable alterations are assigned to the appropriate targeted agent used in combination with a backbone regimen ixazomib, pomalidomide and dexamethasone (IPd), whereas patients without such alterations go on an immune arm (see Table). Inclusion criteria include measurable disease (as measured by M-protein and FLC) and acceptable hematologic and metabolic functions. A maximum of 12 evaluable pts will be accrued onto the phase I portion of each arm and an additional 21 evaluable phase II pts will be accrued onto each arm for a total of 27 evaluable pts at the MTD combination dose. The primary objective of the study is to evaluate ORR per IMWG consensus criteria. Secondary objectives are to assess adverse events (AEs), progression-free survival, and overall survival (OS). Experimental correlative aims include assessing molecular or clonal response, molecular and immune signatures of resistance/response, MRD. Clinical trial information: NCT03732703. [Table: see text]
TECHNIQUES FOR APPLICATION-AWARE SUITABILITY ANALYSIS OF ACCESS CONTROL SYSTEMS

Access control, the process of selectively restricting access to a set of resources, is so fundamental to computer security that it has been called the field's traditional center of gravity. As such, a wide variety of systems have been proposed for representing, managing, and enforcing access control policies. Prior work on evaluating access control systems has primarily relied on relative expressiveness analysis, which proves that one system has greater capabilities than another. Although expressiveness is a meaningful basis for comparing access control systems, it does not consider the application in which the system will be deployed. Furthermore, expressiveness is not necessarily a useful way to rank systems; if two systems are expressive enough for a given application, little benefit is derived from choosing the one that has greater expressiveness. On the contrary, many of the concerns that arise when choosing an access control system can be negatively impacted by additional expressiveness: a system that is too complex is often harder to specify policies in, less efficient, or harder to reason about from the perspective of security guarantees. To address these shortcomings, we propose the access control suitability analysis problem, and present a series of techniques for solving it. Suitability analysis evaluates access control systems against the specific demands of the application within which they will be used, and considers a wide range of both expressiveness and ordered cost metrics. To conduct suitability analysis, we present a two-phase framework consisting of formal reductions for proving qualitative suitability and simulation techniques for evaluating quantitative suitability. In support of this framework we present a fine-grained lattice of reduction properties, as well as Portuno, a flexible simulation engine for conducting cost analysis of access control systems. We evaluate our framework formally, by proving that it satisfies a series of technical requirements, and practically, by presenting several case studies demonstrating its use in conducting analysis in realistic scenarios.
Is SLA Interactionist Theory Relevant to CALL? A Study on the Effects of Computer-Mediated Interaction in L2 Vocabulary Acquisition

1. INTRODUCTIONAccording to interactionist approaches to SLA (Hatch, 1978; Long, 1996),interaction is the most important way in which learners obtain data forlanguage learning. In his most recent version of the Interaction Hypothesistheory, Long (1996) claims that interactive tasks that promote negotiation ofmeaning among learners can facilitate the development of a second language.Negotiation is often product of interactional exchanges where communicationbreakdowns take place. Normally the learner receives interactionally modiﬁedinput, and s/he is also pushed to produce interactionally modiﬁed output(Swain, 1985). In this process, learners notice certain input features, andcompare them with their own output. This noticing (Schmidt, 1990, 1994,1995) has to be present for the input to become ‘intake’. The role ofnegotiation in these exchanges would be that of allowing conscious noticing(Schmidt, 1994, 1996), required to transform input into intake.Likewise, research on SLA conducted from a sociocultural framework,especially that originated under a vygotskyan framework (Vygotsky, 1978),and applied to SLA by Lantolf (2000) among others, also underscorescollaborative learning as paramount to second language acquisition (Otha,1995, 1997, 2000; Swain, 1995, 2000), and emphasizes the importance oflearner-learner meaningful interaction, and especially what Swain (2000) calls‘‘collaborative dialogue’’ for interlanguage development.
The Prevalence of Root Fractures among Patients Visiting a Specialised Tertiary Care Dental Care Clinic

International Healthcare Research Journal 2018;1(12):377-381. DOI: 10.26440/IHRJ/01_12/152 SAVITA SHARMA1, ABHEY CHOWDHRY2 QR CODE INTRODUCTION: Following endodontic therapy, the development of root fracture(s) is considered to be a risk factor. It can be diagnosed accurately with the help of various radiographic aids. AIM: To assess the prevalence of horizontal and vertical root fractures among endodontically treated teeth among patients visiting a specialised tertiary care dental care clinic. METHODOLOGY: Patients suspected of having root fracture (due to endodontic treatment or non-endodontic treatment) were confirmed with the help of radiographic aids (IOPAR, OPG and occlusal radiographs). Root fractures due to endodontic treatment were then classified as horizontal and vertical root factures and analysed using the student’s t-test, ANOVA and odd’s ratio (OR). Data was analysed using SPSS version 21.0 RESULTS: The study population comprised of 383 subjects. Males (207, 54%) formed a majority of the study population. Majority of fractures were seen in females [(162, 58.5%), endodontically treated teeth], while a slightly increased prevalence was seen among males (92, 86.8%) in non-endodontically treated teeth. A total of 277(72.3%) teeth were endodontically treated [155(55.9%) horizontal and 122(44.1%) vertical fracture], while 106(27.7%) were 155 non-endodontically treated teeth [63(59.4%) horizontal and 43(40.6%) vertical fracture]. A significance difference between horizontal and vertical root fractures [p=. 005(t-test), p=. 0025(ANOVA)] was seen. Odd’s ratio analysis revealed that horizontal fractures (OR=2.2) were more prone to develop as compared to vertical fractures. CONCLUSION: Owing to the fact that endodontically treated teeth are more brittle as compared to non-endodontically treated teeth, it is advised that the dental clinician should closely routinely followup endodontically treated teeth for signs of root fracture and confirm with a radiographical aid when such fractures are suspected.
Case studies of instructional practices in proof-based mathematics lectures

This multi-case study investigates the teaching practices of four instructors who were teaching undergraduate level proof-based mathematics courses using lecture methods. Both interview data with the instructors and several video observations of each classroom were gathered throughout the course of a semester. The data analysis techniques were primarily qualitative, but included some quantitative methods such as frequency counts and percentages to give an overall picture of the instructors’ teaching. Analysis occurred in several phases, and used multiple units of analysis including the proof presentations, examples used in proof presentations, the class period, and the individual instructor questions. The first and second research questions addressed the pedagogical moves that the instructor makes during proof presentations, and the instructors’ allocation of class time. The instructors spent between 35% and 70% of their class time presenting proofs. The proof presentation techniques that were identified in the interviews were outline, examples, logical structure, and context. At least one of these strategies was observed in 94% of the proof presentations in the video data. Three of the four instructors expected active engagement in 95% of their proof presentations, while the fourth expected active engagement in 50% of his proof presentations. The proportion of class time spent on interactive lecture ranged from 26% to 62%. The third and fourth research questions addressed the uses, types, and timing of examples during the instructors’ proof presentations. Examples used during the observed proof presentations were used to create a framework that describes the uses of examples, types of examples, and chronological placement of examples in their proof presentations. The fifth and sixth research questions addressed the questions posed by the instructors. The question rates ranged from 0.69 to 1.81 questions per minute, and that the percentage of higher order questions ranged from 30.1% to 54.2%. The percentage of questions to which students responded ranged from 35% to 52%. When restricting to only questions which were answered by students, if was found that in all four cases the percentage of answered questions that were higher-order matched the percentage of asked questions that were higher order. Thus, students were answering a variety of types of questions.
My-Bookstore

This paper describes a learning system, named My-Bookstore, where students buy (make records of) books (paper books) which they have read, and then sell (recommend) the books they like to others. This system is designed to encourage elementary students' classroom reading and book recommendation. The long-term influence of the My-Bookstore system on students' reading in terms of word usage and perception among 204 first-grade students who had used the system for three semesters was investigated. The results indicated that (a) the students borrowed a large number of books and were willing to recommend their favorite books in My-Bookstore; (b) most of the students felt that the overall use experience of the My-Bookstore was attractive, and the goal of the game was relevant to their reading. They also had confidence in recommending books and felt satisfaction when other students accepted their recommendations.