Miracle-dz/UniFAR-FTUs huggingface dataset:
Static Cerebral Blood Flow Autoregulation in Humans

Static cerebral blood flow (CBF) autoregulation maintains a constant CBF despite changes in cerebral perfusion pressure (CPP) within certain limits; this is achieved through adaptive responses in the cerebrovascular resistance, i.e. arteriolar vasoconstriction and vasodilation. This system may protect the brain from hyper- and hypoperfusion upon CPP challenges. CBF autoregulation appears to be mediated through myogenic and metabolic feedback systems, which may involve the vasoconstrictor 20-hydroxyeicosatetraenoic acid as well as an oxygen-sensing mechanism that may involve nitric oxide signalling. Static CBF autoregulation is modulated or impaired in various pathological conditions. In chronic arterial hypertension, both the lower and upper limit of CBF autoregulation are shifted towards higher CPPs; however, CBF autoregulation may be readapted to normal by antihypertensive therapy. Furthermore, CBF autoregulation is impaired in a wide range of clinical conditions, including cerebral ischaemia, traumatic brain injury, intracranial space-occupying processes, subarachnoid haemorrhage, acute bacterial meningitis, fulminant hepatic failure and diabetes. In some of these conditions, CBF autoregulation may be restored by means of hyperventilation and/or induced hypothermia. At present, the clinical impact of CBF autoregulation impairment and of treatment strategies that aim to restore CBF autoregulation remains unclear.
Importância da presença de granulações tóxicas para o diagnóstico hematológico de septicemia

Abstract This work aims at investigating the association of the presence oftoxic granulation with positive blood cultures, age of patients,conditions of hospitalization and types of bacterial agents. Blindprospective and retrospective, analyses were carried out for thepresence of toxic granulations-in blood samples of 300 patients ofthe both genders hospitalized in the City of Belem, Para, Brazil.Request blood tests over a two year period were evaluated. Theblood tests and cultures were performes using automated methods.All the data were statistically compared using the Qui-square test(clump method). The results show statistical associations between:(1) the presence of toxic granulations and positive blood cultures;(2) lower ages of patients (the newborn) and positive blood cultures;(3) hospitalization in the ICU and positive blood cultures and (4)toxic granulations-and the observation of leucocytosis and right-leftshunts in patients hospitalized in the ICU with positive blood cultures.The commonest bacterial agents identified were
A STUDY ON LIPID PROFILES IN CHRONIC LIVER DISEASES

Background: Liver diseases can affect plasma lipid levels in a variety of ways. Chronic liver diseases due to various causes are often associated with dramatic reductions in plasma triglyceride and cholesterol level due to reduced lipoprotein biosynthetic capacity. The study was conducted to determine the lipid profiles in patients with chronic liver disease and to determine if it correlates with the severity of the chronic liver disease. Materials and Methods: In an analytical cross-sectional study, 120 patients with chronic liver disease (case) and 50 age- and sex-matched healthy patients (controls) were studied. Serum triglyceride levels, total cholesterol, HDL, LDL and VLDL were then measured. Child-Turcotte-Pugh Score were calculated for each patient as an index for the extent of liver damage. Results: In patients with chronic liver diseases, with the exception of triglyceride level, there was a significant decrease in total cholesterol, LDL,VLDL and HDL cholesterol levels compared to the control group( p<0.05). However, no significant correlation was found between severity of cirrhosis and change in serum lipid levels. Conclusion: Dyslipidemia exists in patients with liver cirrhosis and screening for the same is important for intervention with appropriate therapy to prevent cardiovascular events.
Role of laboratory diagnostic tests in first febrile seizure

Abstract Febrile seizures are the most common form of convulsions, occurring in 2–5% of children. In the approach to a convulsing febrile patient, discovering the cause of fever and excluding central nervous system infection, serious electrolyte imbalances and other acute neurologic illnesses are essential. History and physical examination may be helpful. The purpose of this study was to evaluate significance of laboratory diagnostic tests other than cerebrospinal fluid examination in first febrile seizures of children. In a descriptive study, medical records of 139 children with first febrile seizure, admitted between March 2004 and August 2005 to Yazd Shaheed Sadoughi Hospital, were evaluated on all laboratory diagnostic done tests (other than cerebrospinal fluid examination), classification of laboratory tests results (normal, outside of normal range, or significantly abnormal), number of significant abnormal tests not predicted by history and physical examination, change in management plan based on biochemical abnormalities and type of febrile seizure. Febrile seizure type was complex in one-third of patients. The number of laboratory tests performed was 9.24 ± 2.4 (range one to 16). Significantly abnormal test results were seen in 12% of patients. Patients less than one year old and those with complex febrile seizures had the greatest number of significantly abnormal test results. Significantly abnormal tests results not predicted by history and physical examination were seen in three cases (one with asymptomatic hypocalcemia and two with urinary tract infection), all of whom were less than 1 year old. Routine blood chemistry analysis is not necessary in children with febrile seizures and only should be ordered based on the patient's condition or medical history.
Analysis of an MAP/PH/1 Queue with Flexible Group Service

Abstract A novel customer batch service discipline for a single server queue is introduced and analyzed. Service to customers is offered in batches of a certain size. If the number of customers in the system at the service completion moment is less than this size, the server does not start the next service until the number of customers in the system reaches this size or a random limitation of the idle time of the server expires, whichever occurs first. Customers arrive according to a Markovian arrival process. An individual customer’s service time has a phase-type distribution. The service time of a batch is defined as the maximum of the individual service times of the customers which form the batch. The dynamics of such a system are described by a multi-dimensional Markov chain. An ergodicity condition for this Markov chain is derived, a stationary probability distribution of the states is computed, and formulas for the main performance measures of the system are provided. The Laplace–Stieltjes transform of the waiting time is obtained. Results are numerically illustrated.
Dual Diagnosis in Older Adults: A Review

Dual diagnosis is associated with frequent relapse, poor treatment engagement and overall unsatisfactory treatment outcomes. A comprehensive review of the contemporary literature examining this issue was conducted, finding a paucity of literature concerning dual diagnosis in older adults. Of the literature appraised for this review, a number of studies examined US Veteran's Affairs populations, which were largely male. Studies concerning older mental health populations were scarce. During the literature search, a number of background studies that influenced contemporary research regarding dual diagnosis in older adults were found; these studies were examined regarding their contribution to contemporary paradigms concerning older adults with co-occurring mental illness and substance use disorders. This review presents the results of the contemporary literature concerning dual diagnosis in older adults. Several recurring themes emerge from the literature, including the notion of a statistically small population that, in absolute terms, represents a sizeable number of individuals coming to the attention of aged mental health services in the future. Additionally, the potential for under-diagnosis in this cohort is highlighted, potentially creating a hidden population of older adults with dual diagnosis.
Childhood Parental Mental Illness: Living with Fear and Mistrust

This paper presents one major theme of findings from a doctorate study. The study used a narrative enquiry approach, to gather parenting narratives of adult children of parents with mental illness. A Partnership Model for a Reflexive Narrative for Participant and Researcher (Partnership Model) was used to invite participants into the study, while encouraging a space for reflection for both the adult children and researcher. In total, 13 adult children participants constructed their narratives of living with childhood parental mental illness, alongside their current parenting role. Their stories reflected childhood experiences of fear and emergence of mistrust of others, particularly their parent with mental illness. For some participants, fear and mistrust continued into adulthood. Many adult children reported their childhood experiences of feeling lonely and isolated. They felt unable to disclose their experiences of parental mental illness to others. In addition, participants were unable to access information about their parent's condition, leaving them feeling unprepared and unskilled, despite their childhood desire to help their parent. This furthermore, compounded their sense of fear and isolation. Early identification of children and families experiencing mental illness is important to facilitate dialogue, psychoeducation and support. Social and health professionals have an important opportunity to enhance the social integration and support for families experiencing parental mental illness, to reduce long-standing fear, isolation and mistrust.
Filtering Disturbances in Schizophrenic Patients. Gating of Auditory Evoked Potentials and Prepulse Inhibition of the Acoustic Startle Response Compared. Emphasis on the Role of Dopamine

Two different paradigms have been used to assess auditory gating in human subjects, namely prepulse inhibition (PPI) of the acoustic startle response (AR or sensorimotor gating) and gating of auditory evoked potentials (AEPs or sensory gating). PPI is the reduction in the ASR that occurs when a weak stimulus (prepulse) precedes a starting stimulus with interstimulus intervals between 30 and 500 ms. PPI has been found to be disturbed in schizophrenic patients. In the sensory gating paradigm, an auditory click (S1) is presented to a subject, eliciting a positive deflection at 50 ms after stimulus onset in the electroencephalogram (EEG). This deflection is referred to as the P50 component. After a brief interval, about 500 ms, a second click (S2) elicits a much smaller P50 in normal subjects, who are said to show normal gating. The reduction in P50 amplitude to the second cick has been found to be less pronounced in schizophrenic subjects. This review discusses the similarities and differences between the AEP gating and PPI paradigms. Emphasis in the discussion is placed on the role of dopamine. Growing evidence from both human an animal studies supports the suggestion that AEP gating and PPI underlie different inhibitory systems. Therefore, it is concluded that PPI and AEP gating have neural substrates that only partly overlap each other and that both paradigms measure distinct types of gating mechanisms.
Lower Extremity Landing Biomechanics in Both Sexes After a Functional Exercise Protocol.

CONTEXT Sex differences in landing biomechanics play a role in increased rates of anterior cruciate ligament (ACL) injuries in female athletes. Exercising to various states of fatigue may negatively affect landing mechanics, resulting in a higher injury risk, but research is inconclusive regarding sex differences in response to fatigue. OBJECTIVE To use the Landing Error Scoring System (LESS), a valid clinical movement-analysis tool, to determine the effects of exercise on the landing biomechanics of males and females. DESIGN Cross-sectional study. SETTING University laboratory. PATIENTS OR OTHER PARTICIPANTS Thirty-six (18 men, 18 women) healthy college-aged athletes (members of varsity, club, or intramural teams) with no history of ACL injury or prior participation in an ACL injury-prevention program. INTERVENTION(S) Participants were videotaped performing 3 jump-landing trials before and after performance of a functional, sportlike exercise protocol consisting of repetitive sprinting, jumping, and cutting tasks. MAIN OUTCOME MEASURE(S) Landing technique was evaluated using the LESS. A higher LESS score indicates more errors. The mean of the 3 LESS scores in each condition (pre-exercise and postexercise) was used for statistical analysis. RESULTS Women scored higher on the LESS (6.3 ± 1.9) than men (5.0 ± 2.3) regardless of time (P = .04). Postexercise scores (6.3 ± 2.1) were higher than preexercise scores (5.0 ± 2.1) for both sexes (P = .01), but women were not affected to a greater degree than men (P = .62). CONCLUSIONS As evidenced by their higher LESS scores, females demonstrated more errors in landing technique than males, which may contribute to their increased rate of ACL injury. Both sexes displayed poor technique after the exercise protocol, which may indicate that participants experience a higher risk of ACL injury in the presence of fatigue.
Nursing students’ attitudes toward patient-centred care in the United Kingdom

Background : Respecting the uniqueness of each individual as part of person-centred approach is central to the provision of high quality nursing care. Valuing people as individuals with different needs and aspirations are attitudes to care-giving that student nurses need to develop. There is however, a scarcity of literature which focuses on assessment of student nurses’ patient-centred attitudes. Aim : To examine patient-centred attitudes among pre-registration nursing students. Design : A validated survey tool developed by Rolfe was used to measure the patient centred attitudes of nursing students in a U.K. University. Methods : The patient-centred attitudes of 149 student nurses were measured using a Patient-Centred Multi-Choice Questionnaire. Standard descriptive analyses were performed. Results : Female student nurses (n=119) undertaking undergraduate pre-registration nurse education, 20- to 29- years-old and in their third year of study dominated the sample group. The mean Patient-Centred Multi-Choice Questionnaire scores for the majority of the sample groups fell within the noticeably therapeutic attitude range. Those that scored highest within the noticeably therapeutic attitude range were males, under 20- years-old, second-year students and students studying children’s health. Conclusion: The relatively high levels of patient-centred attitudes which were evidenced, particularly the results from the male students, is reassuring. The conclusions drawn have implications for nurse recruitment strategies, assessment of prospective student patient-centred attitudes and the teaching, learning and assessment strategies deployed by nurse educators.
Injuries in Japanese Mini-Basketball Players During Practices and Games.

CONTEXT Mini-basketball is one of the most popular junior sports in Japan. Mini-basketball-related injuries may increase because of early specialization. However, no reports have been published to date concerning basketball injuries in children younger than 12 years of age. OBJECTIVE To prospectively study the incidence, sites, types, and mechanisms of injuries in mini-basketball teams. DESIGN Descriptive epidemiology study. SETTING Mini-basketball teams in Kobe, Japan. PATIENTS OR OTHER PARTICIPANTS A total of 95 players in 7 community-based mini-basketball club teams (age range, 9 through 12 years). MAIN OUTCOME MEASURE(S) Data on all practice and game injuries for the 2013-2014 season were collected using an injury report form. Injury rates were calculated according to site, type, and mechanism. RESULTS The overall injury rate was 3.83 per 1000 athlete-hours (AHs). The game injury rate ( 12.92/1000 AHs) was higher than the practice injury rate (3.13/1000 AHs; P < .05). The most common anatomical areas of injury during games and practices were the head and neck (36.4%, 4.70/1000 AHs) and the upper limbs (47.8%, 1.50/1000 AHs). Sprains (42.9%, n = 39) were the most common type of injuries overall, followed by contusions (29.7%, n = 27). Most game injuries resulted from body contact (45.5%, 5.87/1000 AHs), whereas most practice injuries resulted from other contact (56.5%, 1.77/1000 AHs). CONCLUSIONS Game injury rates were higher than practice injury rates in Japanese mini-basketball players. The high practice injury rate in this study may be due to specific factors related to growth, such as individual differences in height, or to skills, such as inexperience in ball handling.
Challenges to determining whether DHA can protect against age-related cognitive decline

Abstract DHA, an omega-3 fatty acid, is an important constituent of brain membranes and has a key role in brain development and function. This review aims to highlight recent research on DHA’s role during age-related cognitive decline and Alzheimer’s disease. Animal and in vitro studies have provided some interesting mechanistic leads, especially on brain glucose metabolism, that may be involved in neuroprotection by DHA. However, results from human studies are more mitigated, perhaps due to changing DHA metabolism during aging. Recent innovative tools such as 13C-DHA for metabolic studies and 11C-DHA for PET provide interesting opportunities to study factors that affect DHA homeostasis during aging and to better understand whether and how to use DHA to delay or treat Alzheimer’s disease.
Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding.

CONTEXT Several factors affect the reliability of the anterior drawer and talar tilt tests, including the individual clinician's experience and skill, ankle and knee positioning, and muscle guarding. OBJECTIVES To compare gastrocnemius activity during the measurement of ankle-complex motion at different knee positions, and secondarily, to compare ankle-complex motion during a simulated trial of muscle guarding. DESIGN Cross-sectional study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Thirty-three participants aged 20.2 ± 1.7 years were tested. INTERVENTION(S) The ankle was loaded under 2 test conditions (relaxed, simulated muscle guarding) at 2 knee positions (0°, 90° of flexion) while gastrocnemius electromyography (EMG) activity was recorded. MAIN OUTCOME MEASURE(S) Anterior displacement (mm), inversion-eversion motion (°), and peak EMG amplitude values of the gastrocnemius (μV). RESULTS Anterior displacement did not differ between the positions of 0° and 90° of knee flexion (P = .193). Inversion-eversion motion was greater at 0° of knee flexion compared with 90° (P < .001). Additionally, peak EMG amplitude of the gastrocnemius was not different between 0° and 90° of knee flexion during anterior displacement (P = .101). As expected, the simulated muscle-guarding trial reduced anterior displacement compared with the relaxed condition (0° of knee flexion, P = .008; 90° of knee flexion, P = .016) and reduced inversion-eversion motion (0° of knee flexion, P = .03; 90° of knee flexion, P < .001). CONCLUSIONS In a relaxed state, the gastrocnemius muscle did not appear to affect anterior ankle laxity at the 2 most common knee positions for anterior drawer testing; however, talar tilt testing may be best performed with the knee in 0° of knee flexion. Finally, our outcomes from the simulated muscle-guarding condition suggest that clinicians should use caution and be aware of reduced perceived laxity when performing these clinical examination techniques immediately postinjury.
Demonstration and nursing clinical teaching - Systematic Literature Review

Objective: This study aimed to carry out a systematic literature review on the effectiveness of demonstration as a clinical teaching strategy for nursing. Method : The search was carried out in articles indexed in online databases: Medline/PubMed, Scielo, BVS-WHO, and PeriEnf during the period 2005-2010. Results: The final sample consisted of 08 studies with level 1 or 2 of evidence. All studies concluded that demonstration is effective for clinical teaching related to psychomotor skills. Conclusion: This literature review concluded that demonstration is higly recommended clinical teaching in nursing as well.
Resolving Ethical Dilemmas: A Guide for Clinicians

The book begins with a concise discussion of clinical ethics that provides the background information essential to understanding key ethical issues. Readers then explore a wide range of real-world ethical dilemmas, each accompanied by expert guidance on salient issues and how to approach them. The book’s two-color design improves retention of material for visual learners. An accompanying website lets readers access the full text, along with features designed to reinforce understanding and test knowledge.
Forensic Psychiatric/Mental Health Nursing: Responsive to Social Need

Forensic nursing is an emerging global nursing specialty, with subspecialties that focus on nursing practice at the clinical-legal interface of tending to victims and offenders, living and deceased. An integrated review of the literature provides an overview of the role development of forensic nursing subspecialties. The subspecialties of forensic nursing that deal with the mental health care of victims and offenders are the focus of this paper. Forensic nursing, like all forensic specialties, developed from a need in society for a medico-legal role. This paper discusses the global role of forensic nursing and argues that role development has been both proactive and responsive to vital needs of victims and offenders in society. Advanced practice forensic nurses have taken leadership roles in the role development of this nursing specialty. A future challenge for forensic psychiatric/mental health nurses with advanced education is to take leadership roles in all areas of psychiatric assessment, intervention, and evaluation of clients.
Water Ingestion Reduced Exhaled Nitric Oxide in the Course of the Osmopressor Response

Water ingestion induces a robust increase in blood pressure (BP) and vascular resistance in patients with an impaired efferent baroreflex. The mild pressor response was also present in elderly healthy subjects; however, there was no change in arterial blood pressure and notably no change, or even a slight reduction in heart rate in young healthy subjects. Nitric oxide (NO) has emerged as a major regulator mechanism of the cardiovascular system and the stressful situation has been linked to a reduction in serum NO.Thus we hypothesized that the exhaled nitric oxide(eNO) might be feasible to be a biomarker that can aid in the research of the osmopressor responses. The purpose of the present study was to examine whether the non-invasive monitor of eNO could reflect the osmopressor response after water ingestion. In a randomized, controlled, crossover fashion, 34 young healthy subjects (age, 22–35 years) ingested either 500 or 50 mL of water. Heart rate, BP, cardiac index, and total peripheral vascular resistance were measured using a Finometer hemodynamic monitor. eNO was determined by a chemiluminescence analyser before and after subjects ingested either 500 or 50 mL of water. Blood sampling for plasma osmolality was performed at 5 min before and at 25 min after either the water ingestion or control session. At 25 min after the ingestion of 500 mL of water, total peripheral resistance increased significantly, and plasma osmolality decreased. eNO decreased significantly at 25 min after ingestion of 500 mL water. This study suggests that water ingestion induced decrease of the eNO might be used as a novel biological marker in the course of the osmopressor response.