Miracle-dz/UniFAR-FTUs huggingface dataset:
Cholecalciferol Supplementation in HIV-Infected Youth with Vitamin D Insufficiency: Effects on Vitamin D Status and T-Cell Phenotype: A Randomized Controlled Trial

Abstract Objectives: In addition to its known effects on bone metabolism, vitamin D may regulate immune function. Design: We performed a randomized controlled trial (RCT) to test whether cholecalciferol supplementation can improve vitamin D status and affect the T-cell phenotype in HIV-infected youth with vitamin D insufficiency. Methods: Fifty-two HIV-infected patients aged 8 to 26 years and with serum 25(OH) D <30 ng/mL were randomized to receive orally vitamin D3 100,000 IU or placebo every 3 months for 4 doses. Serum 25(OH)D, 1,25(OH)2D, PTH, and CD4+ T cells were assessed 3 months before baseline and at 0, 3, 6, 9, and 12 months, while Th1-, Th2-, Th17-, and Treg-subsets and T-lymphocyte vitamin D receptor were assessed at 0, 3, and 12 months. Results: Forty-eight subjects (25 receiving vitamin D and 23 receiving placebo) completed the RCT. Cholecalciferol supplementation produced an early (3 months) decrease in PTH, a concomitant increase in 25(OH)D, and a later (6 months) increase in 1,25(OH)2D levels, all persisting at 12 months. The frequency of vitamin D insufficiency at 12 months was 20% versus 60% in the intervention versus placebo group (P = .007). Cholecalciferol supplementation had no effect on CD4+ T-cell counts but was associated with a decreased Th17:Treg ratio at 3 months. Conclusions: In our cohort of HIV-infected youth, a 12-month cholecalciferol supplementation increased 25(OH)D and 1-25(OH)2D and decreased PTH levels but had no effect on CD4+ T-cells. However, it was associated with changes in CD4+ T-cell phenotype, warranting further investigation.
OC29.03: The Doppler cerebroplacental ratio predicts risk of non‐reassuring fetal status for fetal growth restriction in term pregnancy

gw (RR=6.33) and PD (RR=2.61), p<0.05. The risk for stillbirth after 24 gw was not significantly elevated (RR=1.34). For this complication we observed significant higher rates in pregnancies with PAPP-A MoM < 0.3 MoM (RR=2.9), p<0.05. Conclusion: In the absence of an abnormal karyotype, levels of maternal serum PAPP-A below 0.4 MoM are associated with an increasing risk of adverse pregnancy outcome. This information is useful in counseling women with such results. They may benefit from increased surveillance for these conditions.
Cementum annulations and age determination

Background: Cementum is a hard tissue in the root, which is deposited around dentin in layers throughout life. Under the light microscope, root cementum is seen as alternate light and dark rings known as incremental lines of cementum. In paleontology and forensic medicine, the number of these incremental lines is used to derive the age at death of an individual. Objectives: The present study was undertaken to determine if any relation exists between incremental lines of cementum and age of the individual. Materials and Methods: Twenty-five teeth from patients of known ages and devoid of any pathology such as attrition or hypercementosis were selected for this study. Ground sections were prepared manually. Nineteen of them showed visible countable annulations, while six showed indistinct, invisible annulations and hence were excluded from the study. Half of the selected teeth were sectioned longitudinally and the remainder were cross-sectioned. The mid-root region was selected for counting the annulations. Cemental annulations were counted after taking a photograph and enlarging the mid-root area. Age was then determined by adding the eruption age of the tooth to the annulations counted. Results and Conclusions: It was observed that cemental annulations, when appreciated, can be used as a reliable guide to determine the age of the patient. The age thus determined varied by about 2−3 years from the actual age of the patient. The reliability of the method was found to be 94.73%. There was good interobserver agreement in counting annulations.
PENGARUH TERAPI BERMAIN TERHADAP KECEMASAN ANAK YANG MENJALANI KEMOTERAPI

Cancer is one of the biggest killer diseases in the world. Cancer not only affects adults but children can also be at risk for cancer. Latest cancer treatment for children includes a combination of chemotherapy, radiation and sometimes surgery. Such actions require a very long time and often cause discomfort, side effects and lead to psychological problems. Children who undergo chemotherapy also showed psychological problems such as anxiety and psychosocial distress. One of the ways to minimize anxiety is to be given a child play therapy. Play therapy is a natural way to express the self conflict that not realized by the child himself and the best way to deal with anger, fear and grief. The purpose of this study was to determine the effect of play therapy on anxiety among children undergoing chemotherapy in Pudak Ward of General Public Hospital Sanglah Denpasar. This research is a pre-experimental research design with one group pre-test and post-test design. Sample consisted of 20 pediatric cancer patients were selected by purposive sampling, administered questionnaires to measure anxiety RCMAS anxiety then given play therapy. Based on the paired t-test results, obtained significant value (p) = 0.000 which is smaller than ? = 0.05 (5%). It can be concluded that there is effect of play therapy on children’s anxiety who undergo chemotherapy in Pudak Ward of General Public Hospital Sanglah Denpasar.
Poststroke Upper Extremity Rehabilitation: A Review of Robotic Systems and Clinical Results

Abstract Although the use of robotic devices to address neuromuscular rehabilitative goals represents a promising technological advance in medical care, the large number of systems being developed and varying levels of clinical study of the devices make it difficult to follow and interpret the results in this new field. This article is a review of the current state-of-the-art in robotic applications in poststroke therapy for the upper extremity, written specifically to help clinicians determine the differences between various systems. We concentrate primarily on systems that have been tested clinically. Robotic systems are grouped by rehabilitation application (e.g., gross motor movement, bilateral training, etc.), and, where possible, the neurorehabilitation strategies employed by each system are described. We close with a discussion of the benefits and concerns of using robotics in rehabilitation and an indication of challenges that must be addressed for therapeutic robots to be applied practically in the clinic.
[Quality of life and psychological state in patients with choroidal melanoma: longitudinal study].

UNLABELLED Treatments for choroidal melanoma (CM) generate largely unknown consequences on the level of the quality of life (QoL) and psychological state. Prospective published work is relatively rare and their results are not consistent. The objective of this study is to describe the QoL and psychological state's evolution in patients treated by conservative treatment for CM. POPULATION Sixty-nine patients treated for CM by conservative treatment (proton beam irradiation or iodine plaques). QoL (EORTC-QLQ-C30 + QLQ-OPT-30), anxiety and depression (HADS, STAI-B-trait). DATA COLLECTION Prospective study comprising four evaluations T0: before the beginning of the treatment, T1: one month, T2: six month, T3: one year after the treatment. The preliminary results of the first two evaluations showed that the level of the QoL remained relatively good and stable with an exception for the social functioning, which decreased after the treatment. More than half of the patients had a moderated rate of anxiety before the beginning of the treatment, which decreased significantly a month later. The depressive symptoms were lower and remained stable one month after the treatment. These results confirmed the importance of exploration and screening the fear of cancer recurrence among choroidal melanoma patients.
Patterns of Relationships Between Background Characteristics, Coping, and Stroke Caregiver Outcomes

Abstract Purpose: Little is known about mediators of stroke caregiver outcomes or patterns of relationships of outcome predictors. We examined relationships between the variable sets of caregiver and stroke survivor characteristics, coping (proposed mediators), and caregiver outcomes. Methods: We assessed 253 dyads prior to discharge from acute rehabilitation. Outcomes were depression, anxiety, preparedness, life change, and family functioning. Coping included problem solving, caregiver appraisal, and unmet resource needs. Multivariate canonical correlation analyses were computed between the sets of variables to identify unique patterns of relationships. Results: Six patterns of significant relationships were found (R =.30 to .84, Ps <.01 to .02). The strongest relationship was that between greater threat appraisal and negative life change, greater anxiety, and lower caregiving preparedness (P < .01). Caregiver characteristics (nonwhite, spousal caregivers) were related significantly to several outcomes (positive life change, lower anxiety, and less healthy family functioning) (R = .43, P <.01) and remained significant after controlling for the effect of mediators (R = .32, P < .02). Conclusion: Findings suggest various patterns of relationships that provide guidance for individualizing early caregiver intervention. Clinicians can build on caregivers’ strengths while identifying threats to adaptation to tailor interventions that promote healthy outcomes.
Dual-Task Demands of Hand Movements for Adults with Stroke: A Pilot Study

Abstract For adults with stroke, walking while performing a cognitive task can be challenging, resulting in slower walking, poorer cognitive performance, or decreased performance on both tasks. It is not known if dual-task deficits are also present for upper limb movements for adults with stroke. Purpose: To determine if unilateral movements of the affected and less affected hand are compromised when walking or talking. Methods: Nineteen community-dwelling adults with stroke were video- and audiotaped while performing in single- and dual-task conditions. Tasks included repeated, rhythmic hand movements with the affected and less affected hand, walking a narrow pathway, and speaking. For dual-task conditions, movements of each hand were done while walking and while talking. The rate of hand movement, cadence, and speech rate were analyzed using repeated measures analyses of variance. Results: Affected hand movement rate was the same for single- and dual-task conditions. The rate of less affected hand movement was affected by dual-task conditions; this was due to an increase in hand movement rate while talking. Examination of cadence and speech rates revealed that cadence was decreased when moving the affected hand. Speech rate increased when accompanied by hand movements, but post hoc analyses were not significant. Conclusion: For those with stroke, dual-task deficits are seen with slower walking while moving the affected hand. In contrast, hand movements while speaking may have a more complex relationship, with possible faster speech rates in dual-task conditions.
Recovery of upper extremity motor function post stroke with regard to eligibility for constraint-induced movement therapy.

PURPOSE To examine eligibility for modalities such as constraint-induced movement therapy (CIMT) and modified CIMT (mCIMT) in the subacute phase after stroke and to define the share of patients who should be offered this treatment. METHODS A prospective, repeated-measures design was used. A total of 100 consecutive patients with arm paresis 1 to 2 weeks post stroke were screened. Eligible for CIMT were patients who were cognitively intact, medically stable, and able to extend the wrist and 3 fingers 10° as a lower limit. The active range of motion was registered, and motor function was assessed by the Action Research Arm Test (ARAT) and the Nine Hole Peg Test at 1 to 2 weeks, 4 weeks, and 3 months post stroke. RESULTS From 100 patients, 54 were excluded from motor assessment, mostly due to cognitive impairments. Of the remaining 46 patients, 21 (46%) were eligible according to motor function of the hand at 1 to 2 weeks post stroke, whereas in the other patients motor function was either too good or too poor. The share of patients eligible declined to 31% after 4 weeks and 15% after 3 months. Within 3 months, 60% reached reasonable dexterity, expressed by an ARAT score ≯ 51, all receiving standard rehabilitation. CONCLUSION Results indicate that eligibility for CIMT or mCIMT should not be considered before 4 weeks post stroke because much improvement in arm function was shown to occur during the first month post stroke with standard rehabilitation.
Using Sensors to Measure Activity in People with Stroke

Abstract Purpose: The purpose of this study was to determine the ability of a novel shoe-based sensor that uses accelerometers, pressure sensors, and pattern recognition with a support vector machine (SVM) to accurately identify sitting, standing, and walking postures in people with stroke. Methods: Subjects with stroke wore the shoe-based sensor while randomly assuming 3 main postures: sitting, standing, and walking. A SVM classifier was used to train and validate the data to develop individual and group models, which were tested for accuracy, recall, and precision. Results: Eight subjects participated. Both individual and group models were able to accurately identify the different postures (99.1% to 100% individual models and 76.9% to 100% group models). Recall and precision were also high for both individual (0.99 to 1.00) and group (0.82 to 0.99) models. Conclusions: The unique combination of accelerometer and pressure sensors built into the shoe was able to accurately identify postures. This shoe sensor could be used to provide accurate information on community performance of activities in people with stroke as well as provide behavioral enhancing feedback as part of a telerehabilitation intervention.
Children without parental care in Poland: Foster care, institutionalization and adoption

This article describes the historical background and current situation of the child welfare system for children without parental care in Poland. Nowadays in Poland, most children without parental care still have both parents, but are placed in out-of-home care as a protective measure. Multiple scenarios are possible for these children. Financial resources, however, are often not sufficient to provide the most desirable care. Despite reforms aimed at deinstitutionalization and a growing number of foster care placements in Poland, almost 20,000 children remain in institutional care. For some children without parental care domestic or international adoption is decided.
Development of a Self-Report Scale of Spasticity

Abstract Background: Although the Modified Ashworth Scale is the most common instrument used to grade spasticity, it is unsuitable for busy follow-up clinics, longer term follow-up, or community surveys. Objectives: To establish a simple questionnaire that would indicate the presence and extent of spasticity and would be suitable for use in everyday outpatient clinical practice and/or community follow-up. Methods: Qualitative exploration of the experience and impact of spasticity among stroke patients led to the development of a short questionnaire. Rasch analysis was performed on the data and the scale items were externally validated by correlation with comparator measures. Results: Forty-eight subjects were recruited for the qualitative interviews, half of whom were more than 2 years post stroke. Interviews generated items relating to spasticity that were categorized into pain, spasm, fatigue, restricted movement, loss of balance, and altered appearance. Eight items were chosen for the draft questionnaire. Five hundred questionnaires were sent, and 188 (38%) were returned. The mean age of the 188 responders was 72.6 years. In regard to health, 18.5% reported that they were in good or excellent health, and 49.7% reported only fair or poor health. Data from the 8-item scale were fitted to the Rasch measurement model. Initial fit of the 8 items was good, and all the assumptions of the model were satisfied. A strong and significant gradient was found between the summed 8-item scale and self-reported health. Conclusions: A short self-perceived scale for spasticity has been developed from grounded theory, which satisfies the most rigorous standards for measurement with fit to the Rasch model.
Reliability and Validity of the Arabic Dynamic Gait Index in People Poststroke

Abstract Background and Objective: The Dynamic Gait Index (DGI) is a valid and reliable measure of gait, balance, and fall risk. The purpose of this study was to translate the DGI into Arabic and evaluate the reliability and validity of the Arabic version of the DGI (A-DGI) in patients with stroke. Methods: The DGI was translated into Arabic according to the World Health Organization forward/backward translation protocol for translating assessment tools. It was then administered to a convenience sample of patients with stroke. The inter-and intrarater reliability as well as convergent and discriminant validity of the A-DGI were examined. Results: Fifty-one patients with stroke (mean [SD] age, 64 [12] years; 33 male) were enrolled in the study. The A-DGI score reflected high agreement for both interrater (intraclass correlation coefficient [ICC]3,1 = .98; 95% confidence interval [CI], .97-.99) and intrarater (ICC1,1 = .97; 95% CI, .95-.98) reliability and correlated moderately but significantly with the Glasgow Coma Scale (rho = .39, P = .01), Beck Depression Inventory (rho = -.50, P < .01), and Stroke Impact Scale-16 version 3.0 domains. The A-DGI discriminated between subjects who were at risk of fall and those who were not (U = .00, P < .01), younger and older adults (U = 195, P = .03), side of hemiplegia (U = 218, P = .04), and mild and moderate (U = 105.5, P = .02) as well as mild and severe stroke severity (U = 30, P < .01). Conclusions: The A-DGI reflected high reliability and validity in the stroke population. The availability of a reliable and valid A-DGI facilitates its use among therapists from Arabic origins, which will enrich the rehabilitation process in their clinical practice.
NF-κB Inhibition Ameliorates Angiotensin II–Induced Inflammatory Damage in Rats

We recently reported that the activation of nuclear factor-kappaB (NF-kappaB) promotes inflammation in rats harboring both human renin and angiotensinogen genes (double-transgenic rats [dTGR]). We tested the hypothesis that the antioxidant pyrrolidine dithiocarbamate (PDTC) inhibits NF-kappaB and ameliorates renal and cardiac end-organ damage. dTGR feature hypertension, severe renal and cardiac damage, and a 40% mortality rate at 7 weeks. Electrophoretic mobility shift assay showed increased NF-kappaB DNA binding activity in hearts and kidneys of dTGR. Chronic PDTC (200 mg/kg SC) treatment decreased blood pressure (162+/-8 versus 190+/-7 mm Hg; P=0.02) in dTGR compared with dTGR controls. The cardiac hypertrophy index was also significantly reduced (4.90+/-0.1 versus 5.77+/-0.1 mg/g; P 95% (2.5+/-0.8 versus 57. 1+/-8.7 mg/d; P<0.001) and prevented death. Vascular injury was ameliorated in small renal and cardiac vessels. Electrophoretic mobility shift assay showed that PDTC inhibited NF-kappaB binding activity in heart and kidney, whereas AP-1 activity in the kidney was not decreased. dTGR exhibited increased left ventricular c-fos and c-jun mRNA expression. PDTC treatment reduced c-fos but not c-jun mRNA. Immunohistochemistry showed increased p65 NF-kappaB subunit expression in the endothelium and smooth muscle cells of damaged small vessels, as well as infiltrating cells in glomeruli, tubules, and collecting ducts of dTGR. PDTC markedly reduced the immunoreactivity of p65. PDTC also prevented the NF-kappaB-dependent transactivation of the intercellular adhesion molecule ICAM-1 and inducible nitric oxide synthase. Monocyte infiltration was markedly increased in dTGR kidneys and hearts. Chronic treatment reduced monocyte/macrophage infiltration by 72% and 64%, respectively. Thus, these results demonstrate that PDTC inhibits NF-kappaB activity, ameliorates inflammation, and protects against angiotensin II-induced end-organ damage.
District nurse interaction in engaging with end-stage chronic obstructive pulmonary disease patients: a mixed methods study

disler r & jones a (2010) Journal of Nursing and Healthcare of Chronic Illness2, 302–312 District nurse interaction in engaging with end-stage chronic obstructive pulmonary disease patients: a mixed methods study Aims and objectives. To explore the role of district nurses in caring for people with end-stage chronic obstructive pulmonary disease living in metropolitan London. Background. People with chronic obstructive pulmonary disease experience high symptom burden in their final stages of life. While the majority of end-stage chronic obstructive pulmonary disease patients’ symptoms are markedly similar to any end-stage chronic illness, these patients have limited access to supportive community services, such as district nursing. District nurses have an established role in end-of-life care in the community, however, this care has mainly focused on patients with terminal malignancy. It is unclear why district nurses’ established skills in end-of-life care not are not applied to this high needs patient group. Methods. A mixed-method design incorporating face-to-face interviews and mailed survey was chosen to gain a coherent understanding of the perceptions of district nurses in metropolitan London. Forty-three district nurses participated in this mixed method study in 2008. Conclusions. District nurses were found to lack confidence in their own knowledge about, and in their ability to interact with end-stage chronic obstructive pulmonary disease patients. While district nurses did interact with these patients, this was limited to tasks unrelated to chronic obstructive pulmonary disease. Referrers appeared to misunderstand the district nurse role in end-stage care and therefore its application to the care of end-stage chronic obstructive pulmonary disease patients. Relevance to clinical practice. District nurses need to closely engage with people with end-stage chronic obstructive pulmonary disease. In addition, referrers must alter their discourse to engage these high-risk patients with health services early in their disease trajectory. Infrastructural change is furthermore required to assist district nurses to provide patient-focused care in the community and implement the holistic nursing roles outlined in the literature.
Complaints on Health Services: A Survey of Persons With Disabilities

This study examined the extent to which people with disabilities express their voices and present complaints about the quality of health services, and how their complaints are submitted, compared to nondisabled persons. Data were collected via two national surveys from 243 people with disabilities and 956 nondisabled respondents in Israel who perceived themselves to be aggrieved by their health providers. People with disabilities complained only slightly more often than nondisabled persons, and the majority of complaints were submitted locally and informally by both groups. Since people with disabilities use health services more frequently than nondisabled persons, the fact that a majority of customers with disabilities remains silent causes the health system to lose important information regarding areas for redress or for service recovery. The results have implications for needed actions by health providers and outreach efforts by advocacy groups as well as for further policy and research directions that can improve the quality of health services to people with disabilities.