Miracle-dz/UniFAR-FTUs huggingface dataset:
ISAR-REACT 5 — czy to badanie powinno zmienić praktykę kliniczną?

Prasugrel and ticagrelor are oral P2Y 12 receptor inhibitors indicated by the European Society of Cardiology as the preferred antiplatelet therapy in patients with acute coronary syndromes (ACS). Despite the long-term and widespread presence of these agents in clinical practice, until now they have never been directly compared in a large, randomised clinical trial. ISAR-REACT 5 was the first such study, and it has reported the superiority of prasugrel over ticagrelor. However, due to the questionable methodology of both the planning and the execution of this study, its results should be interpreted with caution, and they should not be considered sufficient to justify any changes to the current treatment strategies for patients with ACS.
Long-term clinical outcomes of scarf osteotomy in regional hospital Hong Kong

Background: Lack of local data concerning the long-term clinical outcomes of scarf osteotomy in Hong Kong. Methods: This is a retrospective review of 75 patients (88 feet) who underwent scarf osteotomy with a mean follow-up of 94.20 months (60–144 months). Clinical ratings were based on visual analog scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) scale. Weight-bearing radiographs were used to perform angular measurements: (i) hallux valgus angle (HVA), (ii) intermetatarsal angle, (iii) distal metatarsal articular angle, and (iv) tibial sesamoid position before operation and at the time of latest follow-up. Results: The mean overall AOFAS scales improved from 29.66 (5–49) points preoperatively to 86.83 (39–100) points at the time of final follow-up. The VAS improved from 6.61 (5 to 9) to 0.66 (0 to 4). The average HVA correction was 25.42 (8–46). The 8- to10-year recurrence rate (HVA > 20) was 31.80%. A higher degree of preoperative HVA predicts higher recurrence rate. Conclusion: Scarf osteotomy is an effective procedure for symptom control and improvement in radiological parameters for hallux valgus deformity. However, recurrence rate is relatively high.
Public expenditure on health promotion and prevention interventions in Austria in 2016

Government and social insurance-funded health promotion and prevention interventions in Austria are surveyed on an irregular basis. Comprehensive data on government expenditures, categorized according to financial providers and/or intervention types had not been published since 2012. In accordance with Austrias current federal target contract, the survey is intended to support the targeted use of funds in the fields of health promotion and prevention by providing timely and detailed information on public spending in these areas. In 2016, the public sector spent 2,441.3 million euros on health promotion and prevention, which corresponds to 280.6 euros per capita (of the Austrian population). Additionally, administrative bodies reported staff-related costs, which could not be monetarily assessed for all administrative levels. 70 per cent of the expenditure on health promotion and prevention incurred by public institutions in Austria went towards tertiary prevention. The shares for primary and secondary prevention are 13.5 and 13.2 per cent respectively, the remaining funds were spent on health promotion and capacity building (3.4 per cent). The collection and coordination effort is considerable for data reporters and study authors, still more frequent collection facilitates data reporting and quality. An overview of the data is still not available at the administrative level of the countries (Länder), this could contribute to informed decisions. Expenditures on health promotion and primary prevention show high growth rates for the period 2012-2016 (+21.3%) reflecting the continuing social importance that this topic has gained in recent years. An allocation of funds to the areas prioritized in the Austrian health promotion strategy 2013-2016 is evident for at least three topic areas.
Estimation of serum lipase as a predicator of acute Pancreatitis

Estimation of serum lipase in case of pancreatitis is very important to reach the diagnosis of disease & its prognosis. It is established fact that test for serum lipase is specific for diagnosis of acute & chronic pancreatitis. Once diagnosis is established, treatment of pancreatitis started. Now serial estimation of serum lipase daily will provide information retarding prognosis of disease also. For example during recovery phase estimation of serum lipase daily will guide to the prognosis of disease. During this phase the serum lipase level goes to the base line. The aim and objective of this work is to predict the disease acute pancreatitis by estimation of serum lipase. Introduction Pancreatitis is a disease characterized by acute inflammation of pancreas with serve pain abdomen, nausea, vomiting & shallow respiration . There is pain on deep breathing. Physical finding on palpation is tenderness in epigastrium, when epigastrium is firmly pressed. Pancreas is one of the important organs in human body system. It is transversely oriented retroperitoneal organ extending from a “c” loop of the duodenum to the hilum of the spleen. Pancreas has two important functions. 1. Endocrine Function– Synthesis of Glucagon, insulin & Gastrin 2. Exocrine FunctionSynthesis of pancreatic amylase and lipase. Normal serum amylase is 0-80 U/L and lipase is < 60U/L. In case of pancreatitis this level in being increased by many fold. In our study the secretion of exocrine gland of pancreas enters in duodenum through opening of pancreatic duct at ampulla of Vater. Therefore in case of perforation of duodenum, also there is chance of increased in level of lipase. Biochemical finding correlated with acute pancreatitis are increased fasting blood glucose, increased serum amylase, decreased serum calcium, increased LHD. A contrast enhanced computed tomography (CECT) scan of abdomen in an important imaging test for acute pancreatitis. Review of Literature A CT severity index can be calculated according to Balthazar, et. al. (API Medicine Pg-1083, editin-10). In acute pancreatitis, a raise in serum amylase activity occurs within 5-8 hours of symptom onset; activities return to normal by the third or fourth day. A four to six fold elevation in http://jmscr.igmpublication. org/home/ ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi. org/10.18535/jmscr/v7i11.51
Prediction of maternal diabetes and adverse neonatal outcome in normotensive pregnancy using serum uric acid

Diabetes mellitus, with adverse neonatal events are challenging issues to all obstetricians and pediatricians, where uric acid could play a vital role. We aimed to assess the relationship and prognostic benefits of serum uric acid measured at about 20 weeks’ gestation in normotensive pregnancy, with subsequent maternal diabetes, and neonatal complications. All singleton normotensive pregnant women with normal blood glucose, serum creatinine, and weight before pregnancy, whom attended Medical City Hospital, Department of Obstetrics and Gynecology in Baghdad, were involved and regarded as the case group, on the condition that their serum uric acid measured at 20 weeks’ gestation > 3 mg/dl, but if ≤ 3 mg/dl, they would be registered as a control group. A complete follow up was performed regularly during pregnancy, and after delivery; regular assessments of maternal blood glucose were done up to one year. Maternal diabetes mellitus (DM), small for gestational age (SGA) neonates, and preterm delivery (PD) constituted (27.59%), (43.60%), and (1.97%), respectively in case group which had significantly included maternal DM and SGA (P <0.001). Also, elevated mid-pregnancy serum uric acid was strongly associated (P <0.0001) with maternal DM (5.86 ± 0.69) and SGA (4.78 ± 0.34). Cut-off values of uric acid of 4.76 mg/dl were best associated with maternal DM, while 4.33 mg/dl with SGA. In conclusion, the cut-off points of 4.76 and 4.33 mg/dl of maternal mid- normotensive pregnancy serum uric acid have the potential ability to predict Maternal DM and SGA, respectively.
High prevalence of diabetes mellitus in Sri Lankan urban population – data from Colombo urban study

Background: In recent decades, Sri Lanka has experienced rapid urbanization, with approximately 30% of the population currently residing in urban areas. We report the age- and sex-specific prevalence of dysglycaemia in an urban population in Colombo, Sri Lanka. Methods: Using a stratified random sampling method, 463 subjects (139 men; 324 women) aged 18 years and above were included. Physical activity was quantified using international physical activity questionnaire (IPAQ). Bio impedence was used to estimate body fat. Insulin sensitivity was estimated using the HOMA calculations. Prevalence was estimated using weighted age standardized calculations. Multiple logistic regression analyses were used to study associations to diabetes and prediabetes. Results: There were 124 adults in the 18-40 age group (70% female), 209 adults in the 41-60 age group (73% female) and 130 adults in the > 60 age group (63% female). The overall prevalence of diabetes was 27.6% (95% CI: 23.7-31.4). The prevalence of diabetes in those aged 18-40 was 12.4% (95% CI: 6.4 -18.4), 36.1% (95% CI: 29.8 – 42.4) in those aged 41 – 60 and 48.3% (95% CI: 40.7 – 55.8) in those aged >60. Pre-diabetes was detected in 30.3% (95% CI 25.9-34.8) of the population (with either an HbA1c of 5.7-6.4%, FPG of 110-125 mg/dl or 2 Hr PPG of 140-199 mg/dl). Cumulative prevalence of diabetes and pre-diabetes in the population was 57.9%. Conclusions: This urban study demonstrates that along with the changes in the socio-demographic status, the metabolic profile of the Sri Lankan adult has transformed, with a high prevalence of dysglycaemia and obesity.
Social Determinants of HIV Treatment Engagement among Postpartum Black Women Living with HIV (WLWH)

of a dissertation at the University of Miami. Dissertation supervised by Professor Rosina Cianelli. No. of pages in text. (170) Engagement in postpartum Human immunodeficiency virus (HIV) treatment is critical to decreasing maternal morbidity and mortality, and poor infant health outcomes. HIV-related maternal morbidity is one of the leading causes of death among women of reproductive age, with as many as 8,500 HIV-infected women giving birth annually in the US. The risk of HIV-related maternal morbidity is greater for Black women who are disproportionately affected by the disease with an infection rate of 59% compared to 20% for Whites, and 21% for other minorities. Black women also have the highest rates of unintended pregnancies, HIV-related mortality, and being lost to follow-up (LTFU) for postpartum HIV treatment. Studies demonstrate that social determinants of health (SDH) can influence the likelihood of engagement in HIV treatment for women living with HIV (WLWH). SDH are the conditions in which people are born, grow, live, work, and age. Poor social and economic situations negatively impact health throughout life, particularly for people living with HIV, and minorities are most likely to live in such conditions. To date, there has been a lack of research on the social determinants of engagement in HIV treatment among postpartum WLWH, particularly Black women who are significantly and disproportionately affected by HIV.
Student's Knowledge, Attitudes, and Practices Related to Cardiopulmonary Resuscitation at Qassim University, Saudi Arabia

Background Cardiopulmonary resuscitation (CPR) is a lifesaving technique that is vital to deal with in many emergencies. Early interference with the cardiopulmonary resuscitation technique is really important for the survival of the patient. This study assesses the level of knowledge, attitudes, and practices regarding CPR among Qassim University students. Materials and methods A cross-sectional study was conducted at Qassim University. The sample was university students. The colleges were chosen by a simple random technique. Data were collected using a pretested, semi-structured questionnaire for knowledge, attitudes, and practices related to CPR. The data were analyzed using Statistical Package for the Social Sciences (SPSS; IBM Corporation, Armonk, NY). Results The total sample size of the participating students was 1148, of which 589 (51.3%) were female and the remaining were male (559, 48.7%). The common age was between 20 and 23 years old and most were from non-medical colleges (54.1%); the remaining (45.9%) were from medical colleges. The majority of female students (45.7%) in medical colleges knew the right location for chest compression better than the males, with a significant difference (p<0.05). No significant difference existed between males and females (p>0.05) regarding most CPR practices. On the other hand, there was a significant increase among medical students as compared to non-medical students (p<0.05) regarding most knowledge, attitudes, and practice items of CPR. Conclusion Based on our study, the knowledge, attitudes, and practices of Qassim University students toward CPR are insufficient and need to be improved. Also, medical students are better than non-medical students at CPR, so we recommend that the incorporation of a Basic Life Support (BLS) course, including CPR learning procedures in the university curriculum, with regular reassessments, would increase the knowledge and application of CPR skills among students for saving people's life.
Repair and Reconstruction of Peripheral Nerve Injuries. Treatment with G-CSF and Stromal Vascular Fraction.

While surgery is a cornerstone in treatment of peripheral nerve injuries, it is not a comprehensive approach, and outcome is unsatisfactory, especially sensory function. The present aim was to translate recent findings about stem- and progenitor cells to improve regenerative outcome, where the cells have to be autologous, available within the same surgical procedure, and minimally manipulated. Granulocyte colony-stimulating factor (G-CSF) mobilizes hematopoietic stem cells from the bone marrow. Post-traumatic G-CSF therapy, evaluated in a rat sciatic nerve injurymodel with immediate repair, showed a 13% local decrease in Schwann cell apoptosis at the site of lesion, and a similar trend in the distal nerve segment in healthy rats, and at the site of lesion in diabetic Goto-Kakizaki rats. G-CSF had no effect on axonal outgrowth in short- or long term experiments.Stromal vascular fraction (SVF) of adipose tissue is a heterogenic mixture of cells, including small amounts of adipose derived stem cells. Electrospun multi-channeled nerve conduits, designed to mimic a native nerve, with longitudinal nanofibers inside the channels for axonal guidance +/- delivered SVF to the nerve conduit was used to bridge a 10 mm sciatic nerve gap in healthy rats. The nerve conduit supported axonal outgrowth and acted as a cell delivery vehicle during the observation time (four weeks). SVF did not improve axonal outgrowth, and adverse effects – gross encapsulation – was observed in 9/30 implants after SVF therapy. Schwann cell infiltration was inferior in nerve conduits supplemented with SVF cells, with a partially enhanced inflammatory response.Co-culture of SVF cells and peripheral nerve segments performed on aligned nanofibers, recreating in vitro the environment above, showed no change in expression of Schwann cell marker S-100 in SVF cells, but increased Sox10 in SVF cells exposed to a nerve segment compared to baseline. Pilot experiments with mass spectrometry indicated a SVF-nerve interplay in the local microenvironment.In conclusion, G-CSF and SVF therapy affected glial cells, but did not improve axonal outgrowth. G-CSF decreases Schwann cell apoptosis, but does not improve regenerative outcome. An electrospun nerve conduit can be used to bridge a nerve gap and act as a cell delivery vehicle. SVF delivered in micro-channels interferes with ingrowth of Schwann cells by unknown mechanisms. (Less)
THE KNOWLEDGE TOWARD OBESITY AND GESTATIONAL WEIGHT GAIN OF PREGNANT WOMEN IN DUHOK CITY

The extensiveness of overweight and obesity among pregnant women is a growing public health concern in the developed countries, as it related to adverse pregnancy outcomes. This problem is considered by World Health Organization as a major health challenges. This study aimed to assess the pregnant women’s knowledge toward obesity, gestational weight gain, and the safe method to prevent this gain. A cross sectional descriptive study was conducted for 400 pregnant women who attended the antenatal care units in eight of Primary Health Care Centers, from 1 st of August to the 20 th of October 2016. They have been directly interviewed by a structured questionnaire to identify their knowledge regarding their weight and Body Mass Index category, their ideas toward the complications of excessive weight gain during pregnancy, and the safe preventive effective management. A bit less than half of the sample (46.3%) were within normal weight, and 208(52%) of participants were overweight or obese, while 137 (36.8%) of them believed that they were overweight and obese. The difference weight gain between first and third trimester of pregnancy was (10.7 Kg), and (91.3 %) agreed that the physical activities and the advices about them were the main ways to prevent the excess weight gain. The majority of pregnant women had limited knowledge about obesity or overweight, excessive gestational weight gain and their adverse effects during pregnancy. The effective media, professional healthcare and providing health education programs are required to improve the level of this knowledge.
Test and treat for dyspepsia—but which test?

genic or mutagenic. Furthermore, these processes mayreduce the efficacy of blood. For example, losses owingtotestsandsafetymeasuresnowreducetheredcellcon-tent of a blood pack by 10%, and some patients willtherefore require more units,adding to the risk.We think that these large and recurring expendi-tures on blood safety should be balanced against thecosts of the clinical trials still needed to provide anadequate evidence base for the use of transfusion,alternatives, and avoidance strategies. The decisionsshould involve a well informed public and beunderstood,and accepted,by them.Brian McClelland
A Study on Adverse Effects of Antidepressants in a tertiary care teaching hospital

Objective: To identify the adverse effects of antidepressants at the initiation of therapy. To make causality assessment of the adverse effect identified using WHO ADR probability scale. Materials and Methods: Patients prescribed with at least one antidepressant were randomly selected and monitored for adverse drug reactions (ADRs), irrespective of their age and gender. Results: Of the 100 patients who received antidepressants, 33 patients experienced 10 ADRs. Selective serotonin receptor inhibitors (SSRIs) were the most common therapeutic class of drugs associated with ADRs. Gastrointestinal system was most commonly affected system organ class. Gastritis and dry mouth were the most frequently reported ADRs. Majority of the ADRs were ‘mild’ in their severity. Conclusion: In this study, incidence of adverse reaction to antidepressants was 32% and the most common group of Antidepressants implicated are SSRIs.
Microsystems culture change: a refined theory for developing person-centred, safe and effective workplaces based on strategies that embed a safety culture

Background: Attending to culture is central to developing workplaces that are safe and effective – those that prioritise learning to support continuing quality, person-centred relationships and the wellbeing of providers and recipients of care. Culture at the microsystems level, where care is experienced and provided, directly impacts on staff and patients but is generally given much less attention than organisational cultures at the meso level. This paper presents a refinement of a previously published middle-range theory of culture change derived from a concept analysis of effective workplace culture. It draws on findings from a project that set out to embed a safety culture and grow quality improvement and leadership capability through a regional patient safety initiative in frontline teams across four acute NHS hospital trusts in south-east England. Aims and objectives: To refine theoretical understanding about how to recognise and develop effective workplace cultures at the microsystems level based on practical insights from the Safety Culture Quality Improvement Realist Evaluation (SCQIRE) project. Methods: The evaluation approach for the SCQIRE project combined realist evaluation and practice development methodology. Realist evaluation was selected to answer the question ‘what works for whom and why when embedding a safety culture, improvement capability and leadership in frontline teams? ’ Key to this approach is the local development, testing and refinement of ‘CMO’ relationships between: contexts (C); mechanisms, for example triggers and explaining why components work (M); and outcomes (O). Drawing on project data, the enablers, attributes and consequences of an effective workplace culture have been used to critically examine the factors that contributed to frontline teams’ ability to create and sustain a safety culture. Findings: A total of 24 CMO relationships resulted in four emerging programme theories that described what worked, why and for whom in relation to: 1) frontline teams developing their safety culture; 2) facilitators working with frontline teams to embed safety culture, quality improvement and leadership; 3) organisations supporting frontline teams; and 4) the patient safety collaborative initiative. Conclusions: It is concluded that the close relationship between person-centred values, ways of working and continuing effectiveness mean it is not possible to develop a safety culture without also being person-centred in relationships. Other theoretical refinements proposed include greater emphasis on the role of appreciative active learning, person-centredness in everyday relationships and an integrated approach to learning, development and improvement embedded at both micro and International Practice Development Journal Online journal of FoNS in association with the IPDC and PcP-ICoP (ISSN 2046-9292) Working together to develop practice Person-centred Practice International Community of Practice