Miracle-dz/UniFAR-FTUs huggingface dataset:
Telemetry guideline awareness leads to a decrease in inappropriate telemetry use

Purpose: Unawareness of telemetry clinical guidelines leads to overuse, inappropriate usage of telemetry monitoring, and longer stays for patients in the emergency department (ED). Provider education on telemetry guidelines was executed to improve appropriate telemetry use. Methods: A retrospective and prospective study using charts analyses of patients at least 18 years old admitted from the ED to three medical-surgical units at a northern New Jersey hospital was performed. Education sessions on the American Heart Association (AHA) telemetry guidelines were provided to the hospital’s healthcare providers. Charts from three months before (n=64) and after (n=64) provider education were analyzed and compared for inappropriate telemetry indications and average ED boarding times. Results: Forty-one cases in the pre-education group and 32 cases in the post-education group were guideline-inappropriate. There was no statistically significant difference in the frequency of inappropriate telemetry indications before and after provider education, x2(1, N = 128) = 2.58, p = . 108. The average ED boarding times in the pre-education group was 92.92 ± 58.02 minutes and 137.16 ± 149.72 minutes in the post-education group. There was no statistically significant difference in the ED boarding times between the pre-education and the post-education groups (U = 1668, p = .07). Conclusions/Implications for Practice: Inappropriate telemetry use decreased from 64% before education to 50% after education, reflecting a descending trend after increasing provider awareness of clinical guidelines. The average ED boarding time was longer in the posteducation group due to multifaceted factors. Continued initiatives in increasing provider awareness on telemetry guidelines are needed.
G282(P) Educational outcomes of helping babies breathe training in rural rwanda

Aims Helping Babies Breathe (HBB) is an evidence-based curriculum designed to teach basic neonatal resuscitation in low-resource countries. The aim of this study is to evaluate acquisition of knowledge and skills following HBB training in a rural district hospital in Rwanda. Method UK volunteers (1 Paediatric Registrar and 1 Paediatric nurse) working for Rwanda Neonatal Care programme collected baseline data using a scenario based objective structured clinical exam (OSCE) and bag valve mask ventilation skills test. Trainees’ skills and knowledge were evaluated using the same simulation scenario before, and 3 months after HBB training to assess retention of skills. All trainees included in the study had no previous HBB training or had completed training longer than 6 months previously. Four physicians and 9 midwives/nurses completed the HBB training package which included bag valve mask ventilation skills practice, 1 to 1 scenario drills, lectures emphasizing the importance of the Golden minute to ventilate, hypothermia awareness and assessment heart rate with consideration of continued resuscitation. ResultsAbstract G282(P) Table 1 Number assessed Passed Average OSCE score (max score 23) Before HBB training Physicians 4 0 9.8 Nurses/midwives 9 2 (22%) 11.5 After HBB training Physicians 4 4 (100%) 22 Nurses/midwives 9 9 (100%) 21.3 Conclusion HBB training resulted in significant increases in mean scores for the OSCE scenario. Although there were fewer physicians assessed, their average score before HBB training was significantly lower than scores of previously untrained nurses or midwives. However, both groups improved their average OSCE scores significantly after training to 100% pass rate (2 tailed comparison of unpaired proportions p<0.0001). Course feedback indicated a need for more sustained skills practice, particularly with bag-mask ventilation. When evaluated 3 months after initial HBB training, OSCE scores showed significant gains in neonatal resuscitation knowledge and skills. Following training, nurses and midwives, who commonly perform these skills in real-life situations, were able to perform at a similar level to physicians. Further studies are necessary to determine how to sustain this knowledge and skills over a longer time period and whether this training translates into improvements in clinical practice.
Magnitude and Predictors of Unplanned Pregnancy among Married Women in Rwanda

Background: Unplanned pregnancy leads to ill health duringpregnancy and perinatal complications. Despite this, there is limitedresearch on the magnitude and predictors of unplanned pregnancy,especially among married women. This study, therefore, aims todetermine the magnitude and predictors of unplanned pregnancyamong married women in Rwanda.Methodology: The descriptive cross-sectional study design wasused. Interview-administrated structured questionnaire was usedto collect data from 383 pregnant legally married women. Theywere selected using multistage sampling method. First 4 healthcenters out of 10 were selected using simple random sampling thenpregnant women were selected randomly according to probabilityproportion to size. Approval to conduct the study was obtainedfrom Mount Kenya university Ethical review committee. Data wereanalyzed through SPSS version 20; logistic regression analysiswas performed to estimate predictors of unplanned pregnancyamong married women.Results: The prevalence of unplanned pregnancy was 30.8% and72.9% of reported unplanned pregnancy was mistimed. In crudeodd ratio, the findings showed that respondents who got marriedbetween 21-24 years were four times more likely to experienceunplanned pregnancy compared to those who married at the ageof 25 years and more. Being married for more than 11 years was asignificant predictor of unplanned pregnancy. In adjusted analysis,women with no formal education/primary education remained athigher risk of unplanned pregnancy (AOR=11.56, 95%CI: 1.918-69.721, p=0.008). Christian women had lower risk of unplannedpregnancy when compared to Muslims (AOR=0.07, 95%CI: 0.009-2.580, p=0.012). Married women who experienced an abortion ormiscarried were at lower risk of unplanned pregnancy (AOR=0.12,95%CI: 0.031-0.465, p=0.002). Conclusion: The prevalence of unplanned pregnancy was highamong married women hence efforts should be put into placestargeting this group.
Studying of heart diseases prevalence, distribution and cofactors in Sudanese population

Background: the following study aimed to reveals the heart diseases (HD) prevalence, distribution and co-factors in Sudanese population during June 2014-June 2015 and to answer the questions related to, in Sudan. Methods: The data collected from different hospitals as gender, age, body mass index BMI, smoking habits, residential states, Pathologies, cardiothoracic ratio CCT, symptoms and breathing rate. Results: showed that HD were predominant among male with 56% and peaked among 65-77 year old, most of sample were either obese or overweight representing 57% or 35% respectively. The common cofactors for HD were the socio-economic, smoking, hypertension and obesity which representing 90%, 75%, 60% and 57% respectively. The heart diseases HD incidence in Khartoum, Aljazeera, White Nile, Red Sea, and West of Sudan was 40%, 25%, 20%, 10% and 5% respectively. The common type of HD was Coronary Arteries, Valves, Myocardial infarction, and Congestive Heart Failure representing 45%, 17%, 23%, and 15% respectively. And signs were Hypertension, Diabetes mellitus, High Cholesterol, breathing rate, edema, palpitation with relative frequencies 9%, 11%, 6%, 12%, 8% and 10% respectively. Patients’ cardiothoracic ratio CTR exceeding normal level (0.5), A significant relationship between CTR and Breathing rate (BR) (R 2 = 0.8) fits in CTR=0.02BR+0.2 as well between age and BR (R 2 ) fits in BR=0.21age + 12.84. And all patients had BR exceeding the adult normal range (12-20). Conclusions: HD could be as endemic to increase mortality following the uneasy avoidable cofactors in the nearest future.
Natural Selection Intensity among Chembadi: An Endogamous Population of Andhra Pradesh

Abstract Information pertaining to fertility and mortality were collected from 240 Chembadi married women (in the age range of 15 to 40 years) belonging to Nellore District, Andhra Pradesh. Based on the data collected, natural selection intensity indices were computed as per the methods described by Crow, Johnston and Kesinger. The results are compared with other endogamous populations of the state and presented here in this paper.
Prenatal weight gain: The relationsihp between food cravings and weight gain

Interventions to date have been minimally effective in reducing the rates of women gaining more weight than recommended by the Institute of Medicine in pregnancy. Food cravings are common in pregnancy, but their relationship, if any, with prenatal weight gain has received little attention in the literature. The purpose of this retrospective chart review study was to describe the frequency of cravings, associations between cravings and weight gain, and to determine what factors were predictive of reporting more cravings in pregnancy. A total of 1,259 charts were reviewed of women receiving care in an urban, community health center between 2006 and 2012. Women with healthy, singleton pregnancies were eligible to be included in the study. Of the 812 eligible women, 620 were excluded due to incomplete data. One-third of women in the sample (n = 194) were primiparous women. Their mean BMI was 28.3 (SD = 6.9). Almost 80% identified themselves as being Multi-Racial or African American. Cravings were reported by 75.3% of women in early pregnancy and 81.4% in late pregnancy. No differences in prenatal weight gain were seen between women with and without cravings. BMI, smoking, stress in early pregnancy, and emotional distress were not related to the numbers of cravings reported in pregnancy. The results of multiple regression analyses indicated that two predictors, age and stress in late pregnancy, accounted for 8.7% of the variance in the numbers of cravings reported in pregnancy (R 2 =.087, R 2 adjusted = .070, F (2, 108) = 5.14, p = . 007). Younger age was associated with reporting a greater number of cravings, β = -. 205, t (110) = -2.222, p =. 028, as was higher stress in late pregnancy, β = . 201, t (110) =2.184, p =. 031. The findings of this study suggest that cravings are not related to prenatal weight gain, although the quality of this study was undermined by its small sample size and problems with the way cravings were measured. Developing a valid and reliable measure of cravings would be a fruitful next step.
Trauma-Informed Elementary Schools: Evaluation of School-Based Early Intervention for Young Children

Trauma-Informed Elementary Schools (TIES) is a program designed to bring trauma-informed services to early elementary classrooms. Built on a foundation of adverse childhood experiences research and the Attachment, Self-Regulation, and Competency framework, TIES provides early intervention to children who exhibit symptoms of chronic stress or trauma in the classroom. Designed as an innovative school-based approach, TIES provides classrooms with a resource liaison to support teachers in recognizing and responding to trauma indicators. This article describes a study that examined the effectiveness of the TIES intervention across multiple domains, measuring the quality of classroom interaction by comparing TIES classrooms with comparison classrooms in 11 schools in a rural Appalachian state. CLASS (Classroom Assessment Scoring System) was used to measure classroom outcomes at the beginning (baseline) and end (follow-up) of the school year. Results indicate that TIES classrooms demonstrated significant improvement from baseline to follow-up in multiple domains, whereas comparison classrooms showed decline. The article concludes with a discussion of the study’s implications.
Key Genes And Pathways Controlled By E2F1 In Human Castration-Resistant Prostate Cancer Cells

Background Treatment of castration-resistant prostate cancer (CRPC) is an enormous challenge. As E2F transcription factor 1 (E2F1) is an essential factor in CRPC, this study investigated the genes and pathways controlled by E2F1 and their effects on cellular behavior in CRPC. Methods In vitro assays were used to evaluate cellular proliferation, apoptosis, and behavior. Cellular expression was quantified by RNA sequencing (RNA-seq). Gene co-expression was assessed using the GeneMANIA database, and correlations were analyzed with the GEPIA server. Altered pathways of differentially expressed genes (DEGs) were revealed by functional annotation. Module analysis was performed using the STRING database and hub genes were filtered with the Cytoscape software. Some DEGs were validated by real-time quantitative PCR (RT-qPCR). Results Knockdown of E2F1 significantly inhibited proliferation and accelerated apoptosis in PC3 cells but not in DU145 cells. Invasion and migration were reduced for both cell lines. A total of 1811 DEGs were identified in PC3 cells and 27 DEGs in DU145 cells exhibiting E2F1 knockdown. Ten overlapping DEGs, including TMOD2 and AIF1L, were identified in both knockdown cell lines and were significantly enriched for association with actin filament organization pathways. TMOD2 and KREMEN2 were genes co-expressed with E2F1; six overlapping DEGs were positively correlated with transcription factor E2F1. DEGs of the PC3 and DU145 groups were associated with multiple pathways. Five DEGs that overlapped between the two cell lines and three hub DEGs from PC3 cells were validated by RT-qPCR. Conclusion The results of this study suggest that E2F1 has a critical role in regulating actin filaments, as indicated by the change in expression level of several genes, including TMOD2 and AIF1L, in CRPC. This extends our understanding of the cellular responses affected by E2F1 in CRPC.
Phase II Study of Low-Dose Decitabine for the Front-Line Treatment of Older Patients with Acute Myeloid Leukemia (AML).

Decitabine (Dacogen™) was recently approved for the treatment of patients with myelodysplastic syndromes (MDS). Response in MDS is associated with reversal of the hypermethylated phenotype of silenced genes. The prevalence of hypermethylated genes contributing to AML progression, coupled with the challenges involved in the treatment of AML in the elderly, is a basis for exploring the activity of decitabine in this patient population. The objective of this phase II trial was to estimate the rate of morphologic complete response (CR) in patients with AML. To be eligible for the study, patients had to be at least 60 years old with newly diagnosed, untreated AML with intermediate- or poor-risk cytogenetics, and they could not be candidates for standard induction chemotherapy. Decitabine was given at a dose of 20 mg/m2 over 1 hour for 5 consecutive days every 4 weeks. At the time of the analysis, 27 patients were enrolled in the trial (14 men, 13 women; median age = 69 years, range = 61–87) and received at least 1 cycle of treatment (median = 4, range = 1–10). Seventeen patients (63%) received 3 or more cycles of treatment. Seven of 27 patients (26%) responded, 2 patients (7%) with a morphologic CR, 1 patient (4%) with a complete cytogenetic response (CRc), and 4 patients (15%) with a morphologic CR with incomplete blood count recovery (CRi) according to AML response criteria (Cheson, JCO 2003). In addition to these defined responses, 11 other patients demonstrated clinical benefit by achieving stable disease, with 4 of these patients having a >25% reduction in bone marrow blasts. Median time to response was 3 treatment cycles. Of the 13 patients with a prior history of MDS, 6 patients had a response (CR, CRc, or CRi, 46%). Two of 2 patients with leukemia cutis exhibited complete resolution of skin lesions and responded (CR or CRi). Eight patients discontinued treatment prior to receiving 3 cycles because of death, progressive disease, or patient decision. All patients were evaluated for safety. Besides myelosuppression, the most commonly reported adverse events considered related to decitabine treatment were fatigue, nausea, febrile neutropenia, vomiting, and asthenia. Decitabine given daily for 5 days showed activity in patients with newly diagnosed AML, with a toxicity profile that was manageable in this older patient population. The results to date are comparable to those from previous studies in AML patients using a variety of decitabine schedules, which have reported CR rates from 14% to 33% (Blood2004;103:1635, Blood2005;106:527a, Cancer2006;106:1794). Updated response and adverse event data will be available at the time of presentation.
Flaxseed and Lower-dose Estrogen: Studies on Their Protective Actions and Mechanisms in Bone Using the Ovariectomized Rat Model

Flaxseed (FS) is a rich source of lignans and n-3 polyunsaturated fatty acids (PUFA), compounds that may help preserve normal bone cell function during aging. Understanding the effect of FS alone or combined with lower doses of estrogen therapy on bone and other estrogen-responsive tissues (e.g. uterus) is of particular interest to postmenopausal women who combine dietary bioactives (e.g. FS) with pharmacological agents (e.g. estrogen monotherapy) to attenuate postmenopausal bone loss. The overall objective of my research was to determine the effects and mechanisms of FS, alone or combined with lower doses of estrogen therapy, on bone and uterus health by measuring a comprehensive set of outcomes in the ovariectomized rat model of postmenopausal osteoporosis. The results demonstrated that FS enhances the protective effect of low-dose estrogen therapy (LD) on vertebral bone mineral density (BMD), three-dimensional microarchitecture and strength in ovariectomized rats. Moreover, FS exerts a stronger effect on bone outcomes when combined with LD than when combined with ultra-low-dose estrogen therapy (ULD). These studies also showed that FS feeding results in higher lignans and n-3 PUFAs in vertebrae, tibias and femurs. Histological analyses at the lumbar vertebra (LV) showed that there were no differences in TRAP-5β, CTX, or OPG/RANKL ratio between the iii FS+LD and LD groups. FS+LD did however result in lower protein expression of osteocalcin, a marker of bone formation and overall bone turnover, and higher expression of OPG compared to the negative control (NEG), while LD did not. While these findings suggest that FS+LD results in greater attenuation of deterioration of bone tissue compared to LD due to a reduction in bone turnover, significant differences between FS+LD and LD were not observed. Elucidating these specific mechanisms of action require further investigation. In the uterus, FS+LD did not induce greater cell proliferation or differences in qualitative indices of uterine morphology compared to LD. These findings suggest that there may be no increase in the risk of endometrial hyperplasia and carcinoma with FS+LD compared to LD. These findings may lead to the development of strategies that combine food bioactives and current pharmacological agents to more effectively normalize bone turnover during aging.
CLOSURE OF OROANTRAL COMMUNICATIONS USING A PEDICLED BUCCAL FAT PAD GRAFT

Background and Aim: The oroantral fistula is one of the complications that might occur following extraction of upper posterior teeth. The use of pedicled buccal fat pad graft has recently been considered in the treatment of oroantral fistula. The aim of this article was to evaluate using pedicled buccal fat pad flap for closure of oroantral communications. Methods & Materials: In this experimental study (case series), thirteen patients (11 male & 2 female) with oroantral communications, which either developed following the extraction of maxillary posterior teeth or odontogenic cyst removal, with an average age of 34.06 (24-52 years old), were treated with a pedicled buccal fat pad graft. Surgeries were performed under local or generalized anesthesia. All of patients were evaluated for maxillary sinus infection before and 6 months after surgery with Water's radiography. Clinical repair of wound was evaluated at the first and the second week and 6 months after the operation. Results: Oroantral communication was treated successfully in all patients. Only one patient complained from pain and nasal obstructions six months following surgery. Conclusion: Pedicled buccal fat pad graft can be successfully used for closure of oroantral communication
Current knowledge and new challenges in exercise immunology

Exercise immunology is a dynamic developing sub-discipline of sports medicine. Although the knowledge about the diverse relationship between exercise and the immune system is profound, the complexity of immunity and its bidirectional interactions with other physiological systems continuously represents an enormous challenge. However, the present review summarizes the current knowledge, new challenges and future directions in the field of exercise immunology. Prof. Dr. Karsten Krüger Justus-Liebig-University Giessen Department of Exercise Physiology and Sports Therapy, Institute of Sports Sciences Kugelberg 62, 35394 Gießen, Germany : karsten.krueger@sport.uni-giessen.de SCHLÜSSELWÖRTER: Entzündungen, körperliche Aktivität, Lymphozyten, Schleimhautimmunität, Neutrophile, NK-Zellen
Perspective of Medical Students of Mashhad University of Medical Sciences about the Criteria of a Good University Professor

Introduction : The main mission of university is training experts who needs in the community, to promote and enhance knowledge, promote research and provide opportunities for developing country. One of the major factors affecting the quality of higher education and teacher education staffing specialist, requires a strong cadre of faculty. This study aims to "Assessment the students' opinion about the criteria of a good teacher" was performed. Materials and Methods : In a descriptive cross-sectional study, 899 students of Mashhad University of Medical Sciences, whom were the randomization and stratified, completed questionnaire. Data were analyzed by Spss 11.5 and appropriate analytic tests. Results: Criteria’s students for a good teacher include: communication skills, knowledge-seeking teaching methods, evaluation skills, then the characteristics and appearance. ANOVA test showed there is a significant correlation between the degree and semester of students and priority communication skills, knowledge-seeking and characteristics of professors (p<0.05(. T-test show that there is the significant relationship between gender and priority of teaching methods, knowledge-seeking and physical characteristics of teachers (p<0.05(. Correlation between age and priority scholarship and physical characteristics of professors is significant(r=0.095 & p<0.05(. Conclusions: Comparing of opinions in different majors students is expressed sympathy of criteria about a good teacher. Communication skills and knowledge-seeking were most important from the perspective of the students.