Miracle-dz/UniFAR-FTUs huggingface dataset:
A Review of Concussion Recognition, Assessment and Management for Paramedics

A concussion (orig. Latin: concutere, "to shake violently”) is a clinical diagnosis of a biomechanically-induced alteration in brain function. This impairment is usually reversible and often affects memory, orientation, and attention. It may or may not cause a loss of consciousness and does not show evidence of brain damage on computed tomography (CT) or magnetic resonance imaging (MRI) scans. (1,2) The internationally accepted consensus definition of concussion incorporates several criteria. (3) 1. Concussion may be caused by a direct blow to the head, face, neck, or elsewhere on the body with an “impulsive” force transmitted to the head. 2. Concussion typically results in the rapid onset of short-lived impairment of neurologic function that resolves spontaneously. However, in some cases, symptoms and signs may evolve over a number of minutes to hours. 3. Concussion may result in neuro-pathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury, and as such, no abnormality is seen on standard structural neuroimaging studies. 4. Concussion results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course. However, it is important to note that in some cases symptoms may be prolonged. Although paramedics are trained in the recognition and management of traumatic brain injuries, the management of the patient with a concussion is a clinical presentation that may not be addressed in sufficient detail within paramedic education, and paramedics may be unaware of the latest evidence-based concussion treatment guidelines and recommendations. While life-support measures are rarely required in concussion injuries, it would be prudent for paramedics to familiarise themselves with this evolving area of concern in medicine. This brief overview aims to address these potential issues.
EFFECT OF SLEEP HEALTH EDUCATION ON THE SLEEP QUALITY OF HEALTHCARE WORKERS IN HEALTH CLINICS: STUDY PROTOCOL

Background: Healthcare workers (HCW) are susceptible to develop poor sleep quality. Those with poor sleep quality are more likely to experience adverse effects on their health and work performance. Sleep health education could be beneficial to improve their sleep quality. Materials and Methods: All eligible HCW from the participating clusters (health clinics) will be recruited. A minimum of 210 participants will be required in the two arm, parallel, cluster randomised trial. Five clusters will be randomly allocated into either intervention group or control group respectively. Intervention group will be given sleep health education whereas control group will be given pre-existing occupational health module on mercury spillage management. Result: The panel of subject experts will be consulted to develop the intervention module. For implementation, the intervention modules will be given to the participants from each group accordingly. For evaluation, sleep quality will be measured based on self-administered questionnaires at baseline and three months post intervention. Data analysis will be done by using Statistical Package for the Social Sciences (SPSS) version 25. Intention to treat analysis will be done with the level of significance set at 0.05 and confidence level at 95%. For bivariate analyses, chi square and logistic regression will be used for categorical variables whereas linear regression for continuous variables. For multivariate analysis, Generalized estimating equations (GEE) will be used to adjust for the clustering effect. Conclusion: Sleep health education, particularly on sleep hygiene practice is essential to improve HCW’s sleep quality. Keywords: study protocol, sleep health education, sleep quality, healthcare workers
A comparative evaluation of serum and salivary albumin in normal, gingivitis and periodontitis patients- A clinico biochemical study

Aim: This study was designed to compare the salivary and serum albumin levels in healthy subjects, patients with gingivitis and chronic periodontitis. Materials and Methods: A total of 60 patients were selected and were divided into three groups (20 subjects each) as healthy, gingivitis and chronic periodontitis. Serum and saliva albumin level were recorded. The unstimulated whole saliva and blood samples from antecubital fossa were collected from the subjects. Bromocresol green method (BCG) used for estimation of both serum and salivary albumin. Results and Conclusion: The results of this study showed significant increase in serum albumin concentrations healthy and gingivitis subjects whereas salivary albumin was higher in gingivitis and periodontitis. Thus, serum albumin and salivaryalbumin concentration may aidin as an important biochemical indicator in assessing the severity of periodontitis. Keywords: Saliva, Albumin, Serum, Periodontitis, Gingivitis.
Autoimmune encephalomyelitis in NOD mice is not initially a progressive multiple sclerosis model

Despite progress in treating relapsing multiple sclerosis (MS), effective inhibition of nonrelapsing progressive MS is an urgent, unmet, clinical need. Animal models of MS, such as experimental autoimmune encephalomyelitis (EAE), provide valuable tools to examine the mechanisms contributing to disease and may be important for developing rational therapeutic approaches for treatment of progressive MS. It has been suggested that myelin oligodendrocyte glycoprotein (MOG) peptide residues 35‐55 (MOG35‐55)‐induced EAE in nonobese diabetic (NOD) mice resembles secondary progressive MS. The objective was to determine whether the published data merits such claims.
Identifying Novel Biomarkers of Metastatic Potential in Prostate and Breast Cancer

of a dissertation at the University of Miami. Dissertation supervised by Professor Nanette H. Bishopric No. of pages in text. (165) Prostate and breast cancers are, respectively, the most common malignancies diagnosed in men and women worldwide. These cancers develop in different organs but have significant biological similarities: both are typically hormone-dependent, and both require early detection and treatment, as the metastatic disease is incurable. Early recognition of which primary tumors are likely to metastasize would help in the diagnosis, treatment, and prevention of metastatic disease. While genetic mutations are intensively studied, and the genomic field is the most advanced to the date in cancer research, many changes in cancer cells found associated with posttranscriptional and posttranslational modifications and remain to be comprehensively elucidated. As an starting approach to discovering aggressive features between genetically similar pair of cell lines, we performed differential Cell-SELEX, an unsupervised screening method, to compae two subclones of a prostate cancer line (LNCaP) with divergent metastatic potential. By sequential negative and positive selection of a short single-stranded RNA molecule (aptamers) library, we identified 691 metastatic cell binding aptamers out of a starting pool of 50 x10 (May 2019) random 40mers. Two aptamers, Aptamer #63 (Apt63) and Aptamer #41 (Apt41), displayed highly specific plasma membrane staining of the metastasis-prone LN3 subclone of LNCap cells, but not the indolent Pro5
Evaluation of YKL-40 in Patients with Type II Diabetes Mellitus with Increasing Levels of Albuminuria

Background and Aim of work: The aim of the present study is to evaluate serum YKL-40 levels in patients with type II diabetes with increasing levels of albuminuria, and to examine a possible correlation to high-sensitivity C-reactive protein (hsCRP) and insulin resistance in these patients. Methods: The study comprised 125 patients with type II diabetes attending Diabetes& Endocrinology Unit in Mansoura Specialized Medical Hospital. They were divided into 3 groups: 39 patients had normoalbuminuria (urinary albumin excretion rate < 30 mg/24 h), 46 patients had persistent microalbuminuria (urinary albumin excretion rate 30–300 mg/24 h), and 40 patients had persistent macroalbuminuria/diabetic nephropathy (urinary albumin excretion rate > 300 mg/24 h). The control group included 35 healthy individuals with matched age and sex. Serum YKL-40 was measured by sandwich enzyme immunoassay and serum hsCRP was measured by particle enhanced immunonephelometry. Insulin resistance was assessed using Homeostasis Model Assessment index for Insulin Resistance (HOMA-IR). Results: Mean serum YKL-40 level was 38.48ng/ml, 75.33ng/ml, 116.87ng/ml and 146.43ng/ml in control, normo, microand macroalbuminuria groups respectively. Serum YKL-40 levels were significantly elevated in the three diabetic groups versus control group (P < 0.001 for each group). Also, YKL 40 was correlated with hsCRP and HOMA-IR (r = 0.746, P < 0.001 & r = 0.792, P < 0.001, respectively) in the total group of participants. ROC curve analysis showed that YKL-40 is a good marker to discriminate between patients with and without albuminuria with sensitivity 93% and specificity of 88%. Conclusion: It could be concluded that YKL-40, is a marker of inflammation and endothelial dysfunction. It is elevated in patients with type II diabetes with marked elevation in patients with macroalbuminuria/ nephropathy. These results suggest a role for YKL-40 in the gradually progressing vascular complications in patients with diabetes, with YKL-40 being a possible early and good marker of renal affection. It seems to be useful for screening because it is detectable in early stages and subclinical diseases.
Impact of IGF-1, GH and Oxidative Stress in the Experimental Model of Juvenile and Adult Hypothyroid Retinal Degeneration

Background: The pathophysiological mechanisms involved in hypothyroid retinal damage are still debate. Materials and methods: To study these mechanisms, ninety six pubs of albino rats were equally divided into three groups, control, hypothyroid model and thyroid supplement. Each group was separated into two juvenile and adult subgroups that were sacrificed at day 20 and 60 postnatally respectively. Pubs in hypothyroid group their mother received 0.05mg carbimazole/day/pregnant female orally during gestation and 20 days of lactation in juvenile subgroup while adult subgroup received the hypothyroid agent until day 60 postnatally. Thyroid supplement group received antithyroid agent then treated with L-thyroxine (TH) orally (10 ug/ kg body weight) for one month. Results: A significant reduction in body weight, temperature, heart rate, levels of T3, T4, GH, IGF-1, and antioxidant enzymes while increased systolic pressure and LP products were evident in hypothyroid subgroups associated with decreased in the thickness and degeneration of retinal layers. Thyroid supplementation group showed a partial normalization of the measured mediators accompanied with recovery of structural changes especially in juvenile subgroup. Conclusions: Thyroid H has a vital role in normal retinal growth. Also, GH, IGF-1, oxidative stress are significant mediators of retinal degeneration.
Canine Assisted Occupational Therapy: Protocol of a Pilot Randomised Control Trial for Children on the Autism Spectrum

Autism spectrum disorder is a neurodevelopmental condition characterised by difficulties with communication, social interaction, and restricted and repetitive behaviours. For children with this disorder, the ability to engage with people and activities, and to participate in everyday occupations is compromised. Animal assisted therapy has been proposed as an intervention modality to facilitate development of an individual’s social behaviours such as engagement and attention. In spite of the increasing evidence showing the positive impact animal assisted therapy can have for children on the autism spectrum, there remain no universal standards or formalised guidelines for ethical practice with either the clients or the therapy dogs involved. The proposed pilot randomised control trial aims to determine the impact of canine assisted occupational therapy on the on-task behaviours and overall goal attainment of children on the autism spectrum, as well as consider the impact that being involved within therapy sessions has on the therapy dog.
Guide to Integrating Forensic Techniques into Incident Response

This publication is intended to help organizations in investigating computer security incidents and troubleshooting some information technology (IT) operational problems by providing practical guidance on performing computer and network forensics. The guide presents forensics from an IT view, not a law enforcement view. Specifically, the publication describes the processes for performing effective forensics activities and provides advice regarding different data sources, including files, operating systems (OS), network traffic, and applications. The publication is not to be used as an all-inclusive step-by-step guide for executing a digital forensic investigation or construed as legal advice. Its purpose is to inform readers of various technologies and potential ways of using them in performing incident response or troubleshooting activities. Readers are advised to apply the recommended practices only after consulting with management and legal counsel for compliance concerning laws and regulations (i.e., local, state, Federal, and international) that pertain to their situation.
Comparison of the Effect of Group and Individual Training on Smoking Cessation Motivation in Coronary Artery Disease Patients

Background & objectives: Quitting smoking significantly reduces the risk of cardiovascular disease and other illnesses associated with smoking. Training seems to be effective in motivating cessation of smoking. The aim of this study was to investigate and compare the effect of individual and group training on the smoking cessation motivation in coronary artery disease (CAD) patients admitted to Avesina Hospital in Qazvin. Methods: This study was a semi-experimental study conducted on smoker patients with diagnosis of CAD who were admitted to Avesina Hospital in Qazvin. 255 patients were enrolled in the study through available sampling. Patients were divided into three groups: individual training, group training and control. A standard two-part questionnaire, which included demographic data and a questionnaire of motivation to quit smoking, was used to collect data. The information was collected before training, and four and three months after the completion of the training. Data were analyzed using SPSS v.24 through descriptive statistic (mean and standard deviation), and chi-square test and one-way analysis of variance. Results: The mean of motivation score for smoking cessation before intervention in 3 groups of control, individual and group training were 9.4±2.7, 8.5±2.3, 8.7±2.4, respectively. At the first follow-up (4 weeks after intervention), these amounts in 3 groups of control, individual training and group training were 8.76±2.9, 13.5±2.5, and 5.2±14 (p= 0/001) and in the second follow-up (3 months after intervention), were 8.18±3.3, 13.3±2.8 and 14±2.7, respectively. Conclusion: The results showed that group training program resulted in increased motivation for smoking cessation. So, designing a group training program can have a significant effect on increasing motivation and creating lasting behavior for smoking cessation in CAD patients.
Comparison between Gingival Pyogenic Granuloma and Peripheral Giant Cell Granuloma by Immunohistochemical Detection of CD34 and Alpha Smooth Muscle Actin

Objectives: The aim of the present research was to study the clinical and the immunohistochemical expressions of CD34 and alpha smooth muscle actin (Î±-SMA) for gingival pyogenic granuloma in comparison with peripheral giant cell granuloma. Methods: Formalin fixed, paraffin-embedded biopsy specimens of (48) gingival pyogenic granuloma and (39) peripheral giant cell granuloma were used in the study. Immunohistochemical analysis for CD34 and Î±-SMA were studied in PG and PGCG. Results: The mean numbers of the CD34 positive micro vessels in PGs and PGCGs were 32. 58Â± 17.778 and 22. 4Â±11.208 respectively. Statistical analysis showed a highly significant difference present between them (P<0.01). The mean numbers of blood vessels with vascular surrounding cells non-reactive to Î±-SMA in PGs and PGCGs were 3. 81Â± 2.228 and 10. 53Â±3.432 respectively. Statistical analysis showed a highly significant differences present between them (p<0.01). Conclusion: The mean number of CD34 positive micro vessels in PGs was significantly more than that of PGCG, but the mean number of vascular surrounding cells non-reactive to Î±-SMA was significantly less. This can add insight to the clinical behavior and might reflect the differences in pathogenesis of these lesions.
Breast radiotherapy in elderly women: myths, controversies, and current techniques in the adjuvant setting

In developed countries, breast cancer (BC) is the most common type of cancer in women, mainly affecting patients over age 60. Due to the increasing life expectancy and population ageing, the incidence of BC is expected to increase significantly in the coming years. However, no standardized clinical guidelines are available to assist in decision-making in elderly patients. Moreover, there is a lack of quality scientific evidence to guide treatment selection in this patient population, who are underrepresented in clinical trials. Consequently, up to 50% of elderly women are treated suboptimally, which implies a worse prognosis and survival. Given that the current estimated life expectancy of a healthy 70-year-old woman is 15 years, any treatment capable of reducing the likelihood of disease recurrence and cancer-specific mortality in this patient population would be beneficial. Adjuvant radiotherapy (RT) is one of the pillars of treatment for BC and it plays a key role in improving local control (LC) and overall survival (OS). Adjuvant RT is clearly indicated in young patients who undergo breast-conserving surgery (BCS) as well as in high risk patients, regardless of age. However, the use of adjuvant RT in older patients with early-stage disease has decreased in recent years—even in patients who undergo BCS—due to outdated concerns about the possible side effects of RT and reports suggesting that RT can be omitted in low-risk patients. One of the greatest challenges currently facing radiation oncologists who specialise in the treatment of BC is the selection of elderly patients who are likely to benefit from adjuvant RT. There is also a clear need to critically evaluate the available evidence and to apply those findings to routine clinical practice. Given this context, the aim of the present review is to clarify the current role of adjuvant RT in the management of BC in older women—particularly those with early-stage disease—and to dispel the myths surrounding the use of RT to treat elderly women. This review primarily focuses on the indications, controversies, and irradiation techniques used in this patient subgroup.
A prospective, multi-institutional study of perioperative morbidities in the patients of renal cell carcinoma undergoing either open nephron sparing surgery or robotic nephron sparing surgery in fifty cases

Background: Over the time, the nephron sparing surgery (NSS) has become ‘gold standard’ for treatment of T1a stage renal cell carcinoma (RCC) which saves precious renal tissue. We assessed and compared perioperative morbidities associated with open (ONSS) and robotic nephron sparing surgery (RNSS) in patients of T1a and T1b staged renal cell carcinoma.Methods: This prospective study was carried out from April 2016 to March 2018. A total of fifty (n=50) RCC patients underwent open or robotic nephron sparing surgery. The demographic data and perioperative morbidities associated with both methods of NSS were recorded and comparison of parameters including warm-ischemia time (WIT), hospital stay, perioperative bleeding, impact of renal-pedicle clamping was made in T1a and T1b staged RCC patients.Results: The most common perioperative morbidity was blood-loss and 12% patients had ≥500 ml loss. Significantly less intraoperative blood-loss was observed in RNSS compared to ONSS with decreased blood transfusion (BT), which decreased significantly after renal-pedicle clamping prior to RCC resection. Even In perioperative period, the blood loss was significantly less in RNSS patients. However, the warm ischemia time (WIT) and hospital stay was longer in patients of RNSS compared to ONSS. The WIT was prolonged in T1b compared to T1a lesions, irrespective NSS methods.Conclusions: Although, the most common perioperative morbidity associated with NSS is blood-loss but RNSS had less perioperative morbidities compared to ONSS. The blood loss decreased significantly during intraoperative period after renal-pedicle clamping which resulted into decreased blood transfusion after NSS by either method.
Health Through Activity: Initial Evaluation of an In-Home Intervention for Older Adults With Cancer.

OBJECTIVE The objective of this study was to assess the feasibility of conducting a future full-scale trial to test the efficacy of an in-home occupational therapy intervention designed to reduce disability in older adult cancer survivors. METHOD Participants reporting activity limitations during or after cancer treatment were enrolled in a Phase 1 pilot randomized controlled trial comparing the 6-wk intervention (n = 30) to usual care (n = 29). Descriptive data on retention rates were collected to assess feasibility of intervention and study procedures. Potential efficacy was explored through participants' self-reported disability, quality of life, activity level, and behavioral activation at 0, 8, and 16 wk after enrollment. RESULTS Retention rates were high regarding completion of the intervention (90%) and outcome assessments (90% of usual-care participants and 80% of intervention participants). Outcomes consistently favored the intervention group, although group differences were small. CONCLUSION The procedures were feasible to implement and acceptable to participants.
Antimicrobial Treatment of Staphylococcus aureus in Patients With Cystic Fibrosis

Staphylococcus aureus is a ubiquitous human commensal pathogen. It is commonly isolated in cystic fibrosis (CF) patients and is considered one of the main causes of the recurrent acute pulmonary infections and progressive decline in lung function that characterize this inherited life-threatening multisystem disorder. However, the true role of S. aureus in CF patients is not completely understood. The main aim of this narrative review is to discuss the present knowledge of the role of S. aureus in CF patients. Literature review showed that despite the fact that the availability and use of drugs effective against S. aureus have coincided with a significant improvement in the prognosis of lung disease in CF patients, clearly evidencing the importance of S. aureus therapy, how to use old and new drugs to obtain the maximal effectiveness has not been precisely defined. The most important problem remains that the high frequency with which S. aureus is carried in healthy subjects prevents the differentiation of simple colonization from infection. Moreover, although experts recommend antibiotic administration in CF patients with symptoms and in those with persistent detection of S. aureus, the best antibiotic approach has not been defined. All these problems are complicated by the evidence that the most effective antibiotic against methicillin-resistant S. aureus (MRSA) cannot be used in patients with CF with the same schedules used in patients without CF. Further studies are needed to solve these problems and to assure CF patients the highest level of care.