Miracle-dz/UniFAR-FTUs huggingface dataset:
Treatment of long-standing complex regional pain syndrome with therapeutic plasma exchange: a preliminary case series of patients treated in 2008-2014.

Dear Editor, The causes of complex regional pain syndrome (CRPS) remain unknown; we have recently confirmed that the transfer of patients' serum immunoglobulin G elicits important CRPS features in hind limb-injured mice, suggesting an autoantibody contribution [1]. Therapeutic plasma exchange (TPE) is an established medical technology, which can remove pathogenic serum components, including antibodies. We report on the treatment of six patients with long-standing, refractory CRPS at two centers, between 2008 and 2009 (N = 3 at Center 1 [C1]) and in 2014 (N = 3 at C2). All patients fulfilled Budapest research criteria for CRPS at the time of treatment. Treatment was conducted after obtaining individual patient consent, and outcomes were recorded in the patient notes (C1), pain diaries, and Brief Pain Inventories [2] completed both before and 1 month after treatment (C2). For C2, the outcome assessment was registered as prospective service evaluation. Short interviews were conducted with all patients by one of the authors (AG) in preparation of this report. TPE is generally applied as a “cycle” of five to seven exchange treatments (ETs) every 1–3 days. All ETs were conducted with one plasma exchange volume, with albumin 4.5% as replacement fluid. 1. A 61-year-old man developed severe right arm CRPS after biopsy of a benign mass in the right axilla. He remained refractory …
The Development and Acceptability of a Mobile Application for Tracking Symptoms of Heart Failure Among Older Adults.

PURPOSE Heart failure (HF) is common in older adults. With increases in technology use among older adults, mobile applications may provide a solution for older adults to self-manage symptoms of HF. This article discusses the development and acceptability of a HF symptom-tracking mobile application (HF app). METHODOLOGY The HF app was developed to allow patients to track their symptoms of HF. Thirty (N = 30) older adults completed an acceptability survey after using the mobile app. The survey used Likert items and open-ended feedback questions. RESULTS Overall, the acceptability feedback from users was positive with participants indicating that the HF app was both easy to use and understand. Participants identified recommendations for improvement including additional symptoms to track and the inclusion of instructions and reminders. CONCLUSION HF is common in older adults, and acceptability of mobile apps is of key importance. The HF app is an acceptable tool for older patients with HF to self-manage their symptoms, identify patterns, and changes in symptoms, and ultimately prevent HF readmission.
Sexual promiscuity among female undergraduates in tertiary institutions in imo state: an issue for healthy living

The study focused on sexual promiscuity among female undergraduates and the attendant health implications. It was carried out in the tertiary institutions in Imo State using 415 final year degree students drawn from four institutions in the State. Three research questions were formulated to guide the study. The design was a descriptive survey. A 12 item questionnaire was structured and validated for the study. Simple percentages were used to answer the research questions. The results indicated the prevalence of sexual promiscuity among female undergraduates, the causes and effects of such unhealthy behaviour on healthy living. Hence, the call for instructional and moral counselling in institutions of higher learning. Recommendations were made based on the findings which, among others was that the counselling Departments in the Universities should organise HIV/AIDS orientation guidance services for greater awareness of the effects of promiscuity. In conclusion, the prevalence and sophistication of sexual promiscuity in the tertiary institutions call for reflections. It is an evil wind that blows no good and should be discouraged in order to maintain healthy female products for productive healthy family living. Key Words: Sexual Promiscuity, healthy living, tertiary institutions
Use of Opioid Analgesics in Older Australians.

OBJECTIVE To identify potential medication management issues associated with opioid use in older Australians. DESIGN Retrospective cross-sectional review of the utilization of analgesics in 19,581 people who underwent a medication review in Australia between 2010 and 2012. SUBJECTS Australian residents living in the community deemed at risk for adverse medication outcomes or any resident living fulltime in an aged care facility. METHODS Patient characteristics in those taking regularly dosed opioids and not and those taking opioid doses >120 mg and ≤120 mg MEQ/day were compared. Multivariable binary logistic regression was used to analyze the association between regular opioid and high dose opioid usage and key variables. Additionally, medication management issues associated with opioids were identified. RESULTS Opioids were taken by 31.8% of patients, with 22.1% taking them regularly. Several major medication management issues were identified. There was suboptimal use of multimodal analgesia, particularly a low use of non-opioid analgesics, in patients taking regular opioids. There was extensive use (45%) of concurrent anxiolytics/hypnotics among those taking regular opioid analgesics. Laxative use in those prescribed opioids regularly was low (60%). Additionally, almost 12% of patients were taking doses of opioid that exceeded Australian recommendations. CONCLUSIONS A significant evidence to practice gap exists regarding the use of opioids amongst older Australians. These findings highlight the need for a quick reference guide to support prescribers in making appropriate decisions regarding pain management in older patients with persistent pain. This should also be combined with patient and caregiver education about the importance of regular acetaminophen to manage persistent pain.
Evaluation of Two Observational Pain Assessment Tools in Chinese Critically Ill Patients.

OBJECTIVES To examine and compare the reliability and validity of two observational pain assessment tools used in a sample of Chinese critically ill patients. DESIGN A prospective observational study. SETTING AND SUBJECTS A convenience sample of 117 adult critically ill patients was recruited from a general Intensive Care Unit in a university-affiliated hospital in China. METHODS Pain was assessed before and during painful and nonpainful routine care procedures (suctioning and noninvasive blood pressure measurement, respectively) using the Critical-Care Pain Observation Tool (CPOT) and the Behavioral Pain Scale (BPS), including the original BPS and the BPS for Non-Intubated patients (BPS-NI). Internal consistency, test-retest reliability, interrater reliability, and discriminant validity of the CPOT and the BPS were evaluated, and the two scales compared. RESULTS A total of 608 assessments were obtained using the CPOT and the BPS. Overall Cronbach's alpha coefficient for the CPOT and the BPS was 0.795 and 0.791, respectively. Test-retest reliability of the CPOT and the BPS was 0.950 and 0.941, respectively. Overall weighted κ between the two raters of the CPOT and the BPS was 0.973 and 0.955, respectively. Scores of the CPOT and the BPS during the painful procedures were both significantly higher than those during the nonpainful procedures, and those at rest before the painful procedures. There was a strong correlation between the two scales with adequate limits of agreement. CONCLUSION Both the CPOT and the BPS are reliable and valid tools to assess pain in intubated and nonintubated critically ill Chinese patients.
T1 mapping of the gadolinium‐enhanced myocardium: Adjustment for factors affecting interpatient comparison

Quantitative T1 mapping of delayed gadolinium‐enhanced cardiac magnetic resonance imaging has shown promise in identifying diffuse myocardial fibrosis. Despite careful control of magnetic resonance imaging parameters, comparison of T1 times between different patients may be problematic because of patient specific factors such as gadolinium dose, differing glomerular filtration rates, and patient specific delay times. In this work, a model driven approach to account for variations between patients to allow for comparison of T1 data is provided. Kinetic model parameter values were derived from healthy volunteer time‐contrast curves. Correction values for the factors described above were used to normalize T1 values to a matched state. Examples of pre‐ and postcorrected values for a pool of normal subjects and in a patient cohort of type 1 diabetic patients shows tighter clustering and improved discrimination of disease state. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.
A study on hearing evaluation in patients of chronic renal failure

Aims and Objective: The aim of the study was to evaluate hearing threshold and the severity of hearing loss at different frequencies (250Hz, 500Hz, 1000Hz, 2000Hz, 3000Hz, 4000Hz, 6000Hz, and 8000Hz) in patients of chronic renal failure (CRF), and to analyze the role of duration of disease on hearing threshold in patients of CRF. Materials and Methods: Fifty two patients of CRF were evaluated in Nephrology unit and ENT OPD. Cases with middle ear involvement were not included in the study. Pure tone audiometry was done in all cases to establish hearing threshold at different frequencies. Cases with hearing loss were classified according to the severity of hearing loss. In patients with sensorineural hearing loss, mean hearing threshold was calculated. Cases were classified in two groups on the basis of duration of disease (less than two years and more than two years) and the mean hearing thresholds were calculated. The significant differences between the mean hearing thresholds of these two groups were assessed using student's t test for unequal samples. Results : A total of 52 patients (28 males and 24 females) were included in the study. Majority of the patients were in 21 to 40 year age group (mean age 36.84 years). Of the 104 ears, 76 ears (73.07%) had sensorineural hearing loss and 28 ears (26.93%) had normal hearing. Majority of the ears with hearing loss had mild (44.73%) or moderate (42.11%) sensorineural hearing loss. Mean hearing threshold was higher at low frequencies and high frequencies with a relative sparing of mid frequencies. Comparison of the mean hearing threshold in patients of Group I (duration of disease less than two years - 42 ears) and Group II (duration of disease more than two years - 34 ears) showed a statistically significant difference ( P Conclusion: Hearing loss is present in majority of the patients of CRF. Most of the cases have mild to moderate sensorineural hearing loss. Hearing threshold worsens at low frequency (250 Hz) as the duration of disease increases.
The Subjective Experience of Pain: An FMRI Study of Percept-Related Models and Functional Connectivity.

OBJECTIVE Previous work suggests that the perception of pain is subjective and dependent on individual differences in physiological, emotional, and cognitive states. Functional magnetic resonance imaging (FMRI) studies have used both stimulus-related (nociceptive properties) and percept-related (subjective experience of pain) models to identify the brain networks associated with pain. Our objective was to identify the network involved in processing subjective pain during cold stimuli. METHODS The current FMRI study directly contrasted a stimulus-related model with a percept-related model during blocks of cold pain stimuli in healthy adults. Specifically, neuronal activation was modelled as a function of changes in stimulus intensity vs as a function of increasing/decreasing levels of subjective pain corresponding to changes in pain ratings. In addition, functional connectivity analyses were conducted to examine intrinsic correlations between three proposed subnetworks (sensory/discriminative, affective/motivational, and cognitive/evaluative) involved in pain processing. RESULTS The percept-related model captured more extensive activation than the stimulus-related model and demonstrated an association between higher subjective pain and activation in expected cortical (dorsolateral prefrontal cortex, ventrolateral prefrontal cortex, insula, dorsal anterior cingulate cortex [dACC] extending into pre-supplementary motor area) and subcortical (thalamus, striatum) areas. Moreover, connectivity results supported the posited roles of dACC and insula as key relay sites during neural processing of subjective pain. In particular, anterior insula appeared to link sensory/discriminative regions with regions in the other subnetworks, and dACC appeared to serve as a hub for affective/motivational, cognitive/evaluative, and motor subnetworks. CONCLUSIONS Using a percept-related model, brain regions involved in the processing of subjective pain during the application of cold stimuli were identified. Connectivity analyses identified linkages between key subnetworks involved in processing subjective pain.
Comparison of symptoms and treatment outcomes between actively and passively detected tuberculosis cases: the additional value of active case finding

SUMMARY Passive detection of tuberculosis (TB) cases may lead to delay in treatment which may contribute to increased severity of disease and mortality. Active case finding may be an alternative. In a community survey in Cape Town, South Africa, we actively detected 27 bacteriologically positive TB cases and compared those with 473 passively detected TB cases. Seven of 27 (26%) actively detected TB cases did not start treatment within 2 months and were considered initial defaulters. Those who did start treatment had similar treatment success rates as passively detected TB cases (both 80%) (OR 1·01, 95% CI 0·33–3·09). Passively detected cases reported the presence of the symptoms cough (OR 3·72, 95% CI 1·47–9·39), haemoptysis (OR 3·20, 95% CI 1·03–9·93), night sweats (OR 3·35, 95% CI 1·40–7·99), fever (OR 4·28, 95% CI 1·21–15·14), and weight loss (OR 11·14, 95% CI 4·17–29·74) more often than those detected actively. We conclude that although TB cases detected by a community survey are less symptomatic and are prone to a high initial default rate, active case finding can potentially identify a substantial portion of the existing caseload at an earlier stage of disease, thereby reducing the risk of transmission.
Effect of climatological factors on respiratory syncytial virus epidemics

SUMMARY Respiratory syncytial virus (RSV) presents as yearly epidemics in temperate climates. We analysed the association of atmospheric conditions to RSV epidemics in San Luis Potosí, S.L. P., Mexico. The weekly number of RSV detections between October 2002 and May 2006 were correlated to ambient temperature, barometric pressure, relative humidity, vapour tension, dew point, precipitation, and hours of light using time-series and regression analyses. Of the variation in RSV cases, 49·8% was explained by the study variables. Of the explained variation in RSV cases, 32·5% was explained by the study week and 17·3% was explained by meteorological variables (average daily temperature, maximum daily temperature, temperature at 08:00 hours, and relative humidity at 08:00 hours). We concluded that atmospheric conditions, particularly temperature, partly explain the year to year variability in RSV activity. Identification of additional factors that affect RSV seasonality may help develop a model to predict the onset of RSV epidemics.
Invasive pneumococcal and meningococcal disease: association with influenza virus and respiratory syncytial virus activity?

SUMMARY Few studies have examined the relationship between viral activity and bacterial invasive disease, considering both influenza virus and respiratory syncytial virus (RSV). This study aimed to assess the potential relationship between invasive pneumococcal disease (IPD), meningococcal disease (MD), and influenza virus and RSV activity in The Netherlands. Correlations were determined between population-based data on IPD and MD during 1997–2003 and influenza virus and RSV surveillance data. Incidence rate ratios of disease during periods of high influenza virus and RSV activity over the peri-seasonal and summer baseline periods were calculated. The analyses comprised 7266 and 3072 cases of IPD and MD. When data from all seasons were included, the occurrence of pneumococcal bacteraemia and MD correlated significantly with influenza virus and RSV activity both in children and adults. Periods of increased influenza virus and RSV activity showed higher rates of pneumococcal bacteraemia in older children and adults than the peri-season period. Rates of MD in children were also higher during periods of increased influenza virus activity; the same appeared true for MD in older children during periods of increased RSV activity. Although no causal relationship may be inferred from these data, they support a role for influenza virus and RSV in the pathogenesis of IPD and MD.
Frequency of physical restraint and its associations with demographic and clinical characteristics in a Chinese psychiatric institution.

PURPOSE Physical restraint (PR) is a highly controversal topic in psychiatry. Little is known about PR among psychiatric inpatients in China. This study examined the frequency of PR and its relationships with demographic and clinical characteristics among a large psychiatric institution in the Hunan Province, China. DESIGN AND METHODS The study included a consecutively assessed sample of 160 psychiatric inpatients. Sociodemographic and clinical data including use of PR were collected from the medical records using a form designed for this study and confirmed via interview. FINDINGS The frequency of PR was 51.3% in the whole sample; 63.2% among female and 39.2% among male patients. In multiple logistic regression analysis PR was independently associated with male gender (p = 0.001, odds ratio [OR] = 0.2, 95% confidence interval [CI] 0.1-0.6), less outpatient treatment prior to admission (p = 0.03, OR = 0.3, 95% CI 0.1-0.9), more frequent use of mood stabilizers (p = 0.002, OR = 5.6, 95% CI 1.9-16.7), more aggressive behavior prior to admission (p = 0.002, OR = 1.1, 95% CI 1.04-1.2), and younger age (p = 0.04, OR = 0.97, 95% CI 0.93-0.99). PRACTICE IMPLICATIONS PR is very common in clinical practice in China. Its demographic and clinical correlates are similar to findings in Western settings.
Care for Postpartum Depression: What Do Women and Their Partners Prefer?

PURPOSE To compare the preferences of those who accept a mental health assessment and those who do not. DESIGN AND METHODS Thirty couples participated in a qualitative study. Nineteen couples accepted a mental health assessment and 11 declined. FINDINGS Acceptors wanted more contact with professionals. Decliners preferred support from their informal network, parental leave, and exercise. However, acceptors also cited these preferences. PRACTICE IMPLICATIONS Nurses should tailor care to couples' preferences, helping them identify and utilize preferred resources. Mental health care might be more acceptable to decliners if provided in obstetrical care.
Effects of an Integrated Stress Management Program (ISMP) for Psychologically Distressed Students: A Randomized Controlled Trial.

PURPOSE This study aimed to evaluate the effects of an integrated stress management program (ISMP) on college life stress, stress coping, psychological distress, and cortisol among male college students. DESIGN AND METHODS Out of 137 initially enrolled students, 99 participants were identified as distressed subjects and randomly assigned to either the ISMP or control group. Ultimately, 84 participants (43: experimental, 41: control) completed pretest-posttest. The experimental group received eight 2-hr sessions over 4 weeks. FINDINGS Stress and psychological distress decreased significantly, whereas stress coping and cortisol did not improve significantly. PRACTICE IMPLICATIONS Further studies with longer follow-up periods and physiological interventions are required.
Zur Anatomie der Venenklappen der V. jugularis interna

Background: Central venous catheters (CVC) in the internal jugular vein have become an important adjunct to the overall management of intensive care patients, but their use is associated with frequent neck complications. In a review of the literature anatomical variation in size, form and function of the valve system of the internal vein was found. Purpose: This study macroscopically and microscopically investigates the anatomical variety of the vein valves of the inferior internal jugular vein. Material and Methods: 100 cadavers from legal autopsies were investigated. We selected 45 patients with an acute myocardial infarction death and a control group (55 patients) formed by different causes of death. The veins were prepared for light microscopic study, the specimens were serially sectioned (ca. 30 sections) and stained with hematoxylin and eosin. Results: Anatomical variety was observed predominantly unilateral on the right side of the internal jugular vein. The valves were often bicuspidal at the right side (92%) and tricuspidal on the left side (64 %) and mostly located ca. 2 cm above the subclavia-jugularis bifurcation. In the histological study, a variability of the net of collagen and elastin fibres in the tunica intima and media was observed. The structure of the adventitia was constant. 18 patients with a jugular valve vein incompetence (age over 60) appeared to have thickening of the tuberculum in the sinus of the valve. The cups of the valves were found rudimentary in these patients with advanced stages of tricuspidal incompetence. Conclusion: The present study demonstrates the variety of the valves of the jugular vein. They play an important role to impede the retrograde flow during cardiopulmonary resucitation as well as in jugular vein cannulation.
Understanding Intimate Partner Violence in Jordan: Application of the Ecological Model

PURPOSE To compare and contrast the Heise "ecological model of gender-based violence" with factors related to "intimate partner violence" (IPV) in Jordan. METHODS Findings of empirical studies examining IPV against Jordanian women were analyzed using the Heise ecological model (1998). CONCLUSION Factors identified in the literature were generally consistent with the ecological model. However, the literature on IPV in Jordan rarely examined the role of community-level factors in the exosystem and sociopolitical factors in the macrosystem. Consequently, little is known about how these exosystem and macrosystem factors affect IPV in Jordan. The Heise model was then adapted to reflect identified factors in the Jordanian cultural context. PRACTICAL IMPLICATION More research aimed at uncovering barriers to identification and treatment of IPV targeting the exosystem and macrosystem is needed.
Exchange‐mediated contrast agents for spin‐lock imaging

Measurements of relaxation rates in the rotating frame with spin‐locking techniques are sensitive to substances with exchanging protons with appropriate chemical shifts. The authors develop a novel approach to exchange‐rate selective imaging based on measured T1ρ dispersion with applied locking field strength, and demonstrate the method on samples containing the X‐ray contrast agent Iohexol with and without cross‐linked bovine serum albumin. T1ρ dispersion of water in the phantoms was measured with a Varian 9.4‐T magnet by an on‐resonance spin‐locking pulse with fast spin‐echo readout, and the results used to estimate exchange rates. The Iohexol phantom alone gave a fitted exchange rate of ∼1 kHz, bovine serum albumin alone was ∼11 kHz, and in combination gave rates in between. By using these estimated rates, we demonstrate how a novel spin‐locking imaging method may be used to enhance contrast due to the presence of a contrast agent whose protons have specific exchange rates. Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.