Miracle-dz/UniFAR-FTUs huggingface dataset:
Study of occult hepatitis B virus infection among the source plasma donors in Sichuan area,China

Objective To investigate the prevalence rate of occult hepatitis B virus infection(OBI) among source plasma donors in Sichuan area,and to evaluate the residual risk of HBV in source plasma under current standards.Methods A total of 135 542 donations,collected from 56 620 donors from July 2007 to July 2009,were tested by PCR kits and ELISA kits for HBV DNA and HBsAg respectively according to the instruction of the kits.PCR positive samples were further analysed by Roche COBAS AmpliScreen,imported ELISA kits,HBsAg neutralization tests and quantitative determination of HBV DNA.Results 12 donations were detected as HBV DNA(+)/ HBsAg(-),for a rate of 0.008 9%(12/135 542). The HBV DNA loads were lower than 1 000 IU/ml.The donations of HBV DNA(+) were tested by imported ELISA reagents and by HBsAg confirmation.The test results demonstrated that 5 of them were positive for HBsAg,and the rest 7 donations(collected from 6 donors) were determined as plasma of OBI with the same serological pattern of HbsAg(-)/ HbeAg(-)/ HbcAb(+). Further trace analysis for 2~9 months showed no change in ELISA and NAT test results.Conclusion There were HBV infected donors in the populations of source plasma donors with negative HBsAg.Based on this study,the prevalence rate of OBI in the population of source plasma donors in Sichuan area was 0.010 6%(6/56 620),lower than several reported OBI rate of voluntary whole blood donors in China.The residual risk of HBV in source plasma tested by domestic HBsAg ELISA reagents was higher than using imported ELISA reagents.Application of nucleic acid technology could further enhance the safety of source plasma.
Summary: Viral Studies of Chronic Fatigue Syndrome

The sudden onset of "flu-like" symptoms that occurs in the vast majority of cases of chronic fatigue syndrome (CFS), followed by persistent illness and fatigue [1-3], suggests a viral etiology for this condition. Over the years, many different RNA and DNA viruses have been suspected of being associated with CFS, but thus far no particular virus has been uniquely linked to this disorder. The presentations and discussions at this meeting strongly supported the hypothesis that CFS may be triggered by more than one viral agent and/ or a variety of organic factors. Komaroff et al. [1] view CFS as centrally an immunologic disturbance that allows reactivation of latent and persistent infectious agents, particularly viruses, in the host. The reactivation of such viral agents may only be an epiphenomenon. Komaroff, however, suggests that once reactivated, these viruses contribute directly to the morbidity of CFS by damaging certain tissues and indirectly by eliciting an ongoing immunologic response. Levy [4] believes that although no viral agent has been found consistently in patients with CFS, an infectious organism may be the cause of this condition and may continue to be present in the individual. Therefore, he has proposed a "hit and run" effect based on the lack of recovery of an agent. According to this hypothesis, a virus might enter the host, cause immune abnormalities leading to CFS, and then be eliminated. The immune system may, however, not fully recover. It thus appears that the reduction in NK cell function [5-7] and/or suppression of CD8+ T cell (CD8+ 1 Ib+ cells) activity is involved.
INTERNAL LUMBAR SPINE MOTION DURING LIFTING

Purpose and Background: Healthy adults with a curvy (lordotic) lumbar spine were shown to lift a load from the floor by stooping, while straight (flat) spines squatted. Since skin-surface motion capture often misrepresents internal curvature this study calculated internal lumbar curvature during lifting in the same cohort and compared lumbosacral motion. Methods: Magnetic resonance imaging (MRI) was performed in standing and bending forward to 30, 45 and 60°, with markers on the skin at L1, L3, L5 and S1. Lumbar spine shape was characterised using statistical shape modelling and participants grouped into ‘curvy’ and ‘straight’ spine sub-groups ( N =8). On a separate day participants lifted a box (6–15 kg) from the floor without instruction while Vicon cameras tracked sagittal movement of L1, L3 and L5 skin markers. Sacral angle (to horizontal) was calculated from pelvic markers. Matching markers during MRI and lifting sessions allowed vertebral centroid positions (L1, L3, L5, S1) during lifting to be calculated using custom MATLAB code. Results: The curvy group had more internal lumbar lordosis at pick up despite stooping to lift the load. From upright standing motion occurred earlier at the upper lumbar levels (L1–L3) compared with lower lumbar (L3–L5). During lifting straight spines had greater rigid-body motion of the entire lumbar spine compared with curvy spines who demonstrated more varied intersegmental motion with greater sacral flexion. Conclusion: Individuals with very lordotic spines retained some degree of internal lordosis despite stooping when lifting. The lumbar spine appears more mobile at the upper levels, L1–L3, and constrained motion was seen in those with the least lordosis.
NGX-4010, a Capsaicin 8% Dermal Patch, Administered Alone or in Combination With Systemic Neuropathic Pain Medications, Reduces Pain in Patients With Postherpetic Neuralgia

Objectives:Analyses of integrated data from 4 controlled postherpetic neuralgia studies evaluated the effect of NGX-4010, a capsaicin 8% patch, administered alone or together with systemic neuropathic pain medications. Methods:Patients recorded their “average pain for the past 24 hours” daily for 12 weeks using an 11-point Numeric Pain Rating Scale (NPRS). Efficacy assessment included the percentage NPRS score reduction from baseline during weeks 2 to 8 and 2 to 12, the proportion of patients responding during weeks 2 to 8 and 2 to 12 and the Patient Global Impression of Change (PGIC) at weeks 8 and 12. Results:During the studies, 302 NGX-4010 and 250 control (capsaicin, 0.04% wt/wt) patients were using at least 1 systemic neuropathic pain medication; 295 NGX-4010 and 280 control patients were not. During weeks 2 to 8, NGX-4010 patients reported greater reductions in NPRS scores compared with control both in patients using systemic neuropathic pain medications (−26.1% vs. −18.1%, P=0.0011) and in patients not using these medications (−36.5% vs. −26.2%, P=0.0002). Patients not using systemic neuropathic pain medications reported a greater reduction in pain compared with patients using these medications in both, NGX-4010 and control groups, resulting in comparable treatment differences between NGX-4010 and control regardless of systemic neuropathic pain medication use. Similar results were seen during weeks 2 to 12, for the responder and PGIC analyses. Transient, capsaicin-related application site reactions were the most common adverse events and not affected by systemic neuropathic pain medication use. Conclusion:A single 60-minute NGX-4010 treatment reduces PHN for up to 12 weeks regardless of concomitant systemic neuropathic pain medication use.
SURGICAL SITE INFECTION IN SURGERY WARD AT A TERTIARY CARE HOSPITAL: THE INFECTION RATE AND THE BACTERIOLOGICAL PROFILE

Background: Surgical Site Infections (SSI) constitute a major fraction of nosocomial infections and occur in superficial incisional, deep incisional, and organ\space locations. The bacteriological profile of SSI and their antibiotic-susceptibility-pattern; aims towards planning proper treatment of SSI. Objectives: To determine the SSI rate MIS (Minimally Invasive Surgery) vs OS (Open surgery) during the study period, the bacteriological profile of SSI & their antibiotic-susceptibility-pattern, and to build up guidelines for empirical treatment of SSI till antibiotic sensitivity results are procured. Design: Prospective, randomized, hospital based study. Materials and Methods: The study included 784 patients; undergoing either OS or MIS\laparoscopic surgery from May 2009 to April 2011; at surgery department of hospital, among which; 72 cases of SSI was observed. Aspirated secretion\pus\wound swab was obtained from operation site of all the cases and cultured aerobically and an-aerobically using standard microbiological techniques. For control, skin swabs were collected from proposed incision site; prior to surgical draping; and bacterial culture attempted in all the subjects. The isolates were processed as per standard test guidelines. Antibiotic susceptibility tests were done by Kirby-Bauer technique. Results: Rate of SSI was 2.06% vs 16.16% in MIS vs OS. Most predominant pathogen was Staphylococcus aureus, predominantly Oxacillin resistant Staphylococcus aureus (ORSA-56.5%). Superficial SSIs were predominated by S.aureus. Deep SSI was predominated Klebsiella sp. ORSA were highly sensitive to vancomycin and linezolide. All ESBL producing isolates were highly sensitive to imipenem. Conclusions: Multidrugresistant (MDR) bacteria have profound role in SSIs. Empirical antibiotic therapy essentially to be started at clinicians end; before receiving the antibiotic susceptibility test results; may include therapy with amikacin and piperacillintazobactum or amikacin and cefoperazonesulbactum & must be switched over to vancomycin or linezolide when ORSA is the causative agent or, to other suitable antibiotics in case of ESBL producing etiology; strictly; as directed by microbial culture and antibiotic susceptibility test report. Keywords––Antibiotic stewardship, Empirical antibiotic therapy, Minimally invasive surgery, Multidrugresistant bacteria, Open surgery, Oxacillin resistant Staphylococcus aureus, Surgical site infection
Dental Pain Simulation Model Based on Biorhythm Charts Within the Diagnosis and Treatment Expert Systems

ciple toward the field of friendly treatments by assessing the potential interaction between the moment in which dental pain occurs and the physical and emotional biorhythm cycles, within a diagnosis and treatment expert systems. Material and method: The study was performed upon 461 patients out of which 120 (21%) accused pains from acute pulpitis and the rest pains from acute apical periodontitis. The date that pain started and the birth date of each patient were taken into evidence, and based on this info, an individual biorhythm interpretations was created, using a specialized software. The physical (F) and the emotional (E) cycles were revealing to the study. Results and discussions: The results are read by interpreting the position of the sinusoidal curve at the date when pain occurred as compared to the time axis. Unfavourable results are considered those at the critical points and at the descending ones, be they above or below zero. Out of the entire group, 35% of patients were situated at the critical point, and 40% were in deficit within their physical and emotional cycles. Out of the patients accusing acute pulpitis, 20% of patients were at the critical point and 51.6% were in deficit within the physical and emotional cycles. Out of the acute apical periodontitis group, 14,1% of the patients were at the critical point and 53,9% were in deficit. Conclusions: establishing the suitable time for successful treatment could induce a new perspectives in dentistry treatment techniques in line with the new vision of sustainable medicine.
O processo de enfermagem na matriz curricular de escolas formadoras de técnicos de enfermagem

The nursing process, defined as a methodological instrument for caring, must be developed by every member of the nursing staff, so that it can be effective. The present article consists of a documental study aiming at examining the syllabus of pedagogic political projects of technical nursing schools in Joao Pessoa – PB as for the teaching and the nursing process application, the participation of these professionals is fundamentally important for the care system, function of the schools being to prepare them appropriately. The study was developed in the year 2006. The data were analyzed focusing the qualitative method, using the technique of content analysis. It was verified that there are no indications of the teaching of the nursing process in any discipline in the syllabus of the participant schools of the study, although there is indication of their application in few disciplines of some schools. So, it is a duty to the schools to revalue their syllabus, in way to insert this thematic to qualify better the nursing technicians to give systematized and qualified care. Key words: Nursing; Nursing Process; Education; Nursing, Associate.
The Disconnect Between Research and Current Coaching Practices

ABSTRACT TODAY'S COACHES DO NOT USE MANY OF THE CURRENT RESEARCH RECOMMENDATIONS FOR PRE- AND POST-STRETCHING, EVEN THOUGH MANY OF THEM HAVE COMPLETED CERTIFICATION PROGRAMS DESIGNED TO HELP THEM DEVELOP EVIDENCE-BASED PRACTICES. THIS ARTICLE WILL BRIEFLY REVIEW THE CURRENT RECOMMENDATIONS FOR STRETCHING AND PRESENT DATA THAT SHOW A LACK OF COMPLIANCE WITH THESE RECOMMENDATIONS. THE PURPOSE OF THE DISCUSSION WILL BE TO IDENTIFY THE EXTENT TO WHICH CERTIFICATION MIGHT AFFECT COACHING PRACTICES.
Outcome of Pregnancies among Cameroonian Anemic Women: A Comparative Cohort Study

Objective: To evaluate maternal and fetal outcomes among Cameroonian anemic pregnant women according to the degree of correction of anemia. Methods: This cohort study was conducted in the Yaounde University Teaching Hospital, Cameroon, from March 1st, 2011 to February 28th, 2013. Anemic pregnant women (initial Hemoglobin concentration (Hb) <10 g/dl) and nonanemic pregnant women (Hb ≥ 11 g/dl) were followed up till delivery. Variables measured were gestational age at the first visit (booking), Hb value at the first consultation and at 36 weeks gestation, pregnancy complications, gestational age at delivery, birth weight (BW) and Apgar score. Data were analyzed using SPSS 18.0. Chi square test or Fisher exact test and t-test were used for comparison. P<0.05 was considered statistically significant. Results: Hb still less than 9 g/dl at 36 weeks gestation was associated with an increased risk of low BW (RR 7, 95%CI 1.6-30.4), pre-eclampsia (RR 3.3, 95%CI 0.9-11.9) and preterm deliveries (RR 3, 95% CI 0.6-14.6). Mean BW observed among initially anemic women with Hb ≥ 10 g/dl at 36 weeks gestation was higher than that found among women of the non anemic group (P<0.0001). Conclusion: Hb still less than 9 g/dl at 36 weeks gestation was associated with increased risk of low BW while anemia corrected with iron and folic acid before term was associated with a significant increase in BW.
Quantitative Sonographic Assessment in the Clinical Management of Superficial Digital Flexor Injuries in Thoroughbred Racehorses

This study demonstrates that a quantitative sonographic assessment using a systematic, routine evaluation can provide objectivity for clinical information and improve the ability to render an accurate prognosis. Categorization of tendon injuries can assist the practitioner in determining the potential for continued racing and the risk of additional tendon injury. Authors’ address: Randall Veterinary Hospital, 20600 Miles Parkway, Warrensville Heights, OH 44128-5504. r 1997 AAEP.
Un nouveau mode de régulation dans un système décentralisé: l'Etat évaluateur: l'Etat évaluateur

L'evaluation est un dispositif d'importance croissante pour le pilotage et la qualite des systemes educatifs. L'article compare sur ce point les traditions fort differentes de l'Angleterre et de la France. Il examine les implications de ces dernieres sur les tensions sociales, economiques et politiques a l'oeuvre dans les deux pays
Gender Differences in Experienced Pain, Mood, Energy, Appetite, and Sleep by Cancer Patients in Palliative Care

Purpose: The aim was to study gender differences in pain and quality indicators of terminally ill cancer patients in advanced home care. Method: A descriptive, not randomised study with self-reported questionnaires about experiences of pain, energy, mood, appetite, and sleep. The 27 patients filled in the questionnaires every day during a period for 4 weeks. Main research variables: Pain was measured with VAS (Visual Analogue Scale). The quality indicators, such as mood, energy, appetite, and sleep were measured on the DT-scale (Delighted Terrible-scale). Findings: Women experienced significantly more pain over time than men, and overall the results showed significant gender differences in the correlation between pain and quality indicators. Conclusions: Both women and men with cancer spent their last time in life in low QoL (Quality of Life) in a state of moderate pain. Despite their hopeless situation in life the estimated experience of quality was around 50% of the highest possible value. Implications for Nursing Practice: If patients with cancer are spending their last time in life with a poor QoL and with persistent experience of pain, it is of great importance that nurses are educated in palliative care. From this study it has been shown that the value and special nature of nurses' role encompasses several dimensions, but the skill of providing comprehensive care is to be based on knowledge, wisdom, and personal strength. Therefore it will be a great challenge for nurses to handle and support the patients to perform this kind of care.
The learning culture in third year clerkships: medical students' perceptions through a coaching lens.

Purpose: Medicine is rapidly changing. New clerkship models have been proposed, including coaching. The authors studied a group of individuals able to comment on both worlds: medical students who had been coached to high levels of performance in sports, music, and debate. The study was undertaken to understand the learning culture in the clerkships and whether it was similar to the students’ previous coaching experiences. Method: Using a constructivist grounded theory approach, the authors conducted two focus groups with 23 students. Data were analyzed iteratively using constant comparison. Key themes were identified to obtain a conceptual understanding of coaching and clerkships. Results: Five types of learning events regularly occurred between coaches and students, and a sixth was unique to medical students in the clerkships. These were: relationship with the teacher, expectations, observation, practice, feedback, and measures of success (in the clerkships). The five events associated with coaching were noted as strengths by students, while the same five were noted as weaknesses in the clerkships. Conclusion: Medicine’s current learning culture makes it difficult for teachers to impact learners’ development, making thoughts about incorporating coaching into clinical settings problematic. The culture must be addressed, so that coached deliberate practice may be used. Medical training began with an apprenticeship model for learning clinical skills. Although there were certainly disadvantages to this kind of training as reflected in the Flexner report, the apprenticeship model did have its advantages. The function of apprenticeships is to bring learners from the periphery of participation (as an observer) progressively into the center of a community of practice as their skills improve (Lave & Wenger, 2003). That is, master physicians had their apprentices simply observe in the beginning, but gradually increased their involvement in patient care until they could care for patients as competent physicians. The speed of this evolution was determined by the master, based on a longitudinal relationship with his apprentice and hours of direct observation, practice and feedback. This required skills on the part of the master very similar to that of a coach today, although it is doubtful that the masters called what they were doing by that name.
Comparison of Clinical and Radiological Features of Aspergillus, Zygomycosis, and Fusarium Pneumonia in Neutropenic Patients

BackgroundOpportunistic fungal pneumonia in neutropenic patients due to hematologic malignancy or bone marrow transplant continues to rise, and the diagnosis remains challenging. We sought to compare the clinical and early radiological patterns of 3 fungi (Aspergillus, Fusarium, and zygomycosis) in this population to facilitate early diagnosis and improve choice of early empiric therapy before culture results are available. MethodsThis is a retrospective chart review study conducted between January 1999 and June 2010 in neutropenic patients with fungal pneumonia. Clinical and radiological features, duration of neutropenia, underlying illness, culture results, treatment choice, and outcome were recorded for each patient. ResultsTotal of 74 patients with fungal pneumonia met inclusion criteria: 27 had Aspergillus, 25 had Fusarium, and 22 had zygomycosis pneumonia. The following were the findings:Underlying diagnosis: Acute myeloid leukemia was the most common underlying diagnosis in any fungal pneumonia, present in 42 (57%) of the 74 patients.Clinical features: Toe cellulitis was present in 34% of Fusarium pneumonia cases. Blood culture positive for the fungus in 10% of the Fusarium cases. Other clinical features were reported in similar frequencies in all types of fungal pneumonia.Radiological patterns: In 20 (80%) of 25 cases of Fusarium, early lung nodules were multiple (>2) and small with an average diameter less than or equal to 1 cm at initial computed tomography scans (size: minimum 0.1, median 0.8, maximum 2.8 cm). Sixteen (67%) of 24 cases of early nodules caused by Aspergillus and 13 (72%) of 18 cases of early nodules caused by zygomycosis had a bigger size at diagnosis (size: minimum 0.3, median 1.8, maximum 4.3 cm for Aspergillus; and minimum 0.5, median 2.1, maximum 4.5 cm for zygomycosis) (P < 0.0001) and were few in number. Fusarium lung nodules had a scattered (central and peripheral) distribution in 76% of cases. Nodules caused by Aspergillus and zygomycosis were located peripherally, in 75% and 78% of cases respectively.Duration of neutropenia: The median duration of neutropenia was shorter with an average of 18 days (minimum, median, maximum = 1, 10, 60 days, respectively) at the time of invasive Aspergillus diagnosis in contrast to that for Fusarium with an average of 48 days (minimum, median, maximum = 7, 26, 128 days, respectively) and an average of 45 days in cases due to zygomycosis (minimum, median, maximum = 4, 28.5, 105 days, respectively) (P < 0.0001). Initial treatment and outcome: Voriconazole was used empirically initially in 53 (72%) of the 74 patients. Mortality at 3 months for all fungi was 64%, highest for zygomycosis (67%) followed by Aspergillus (63%) and Fusarium (55%). ConclusionsClinical and radiological patterns and duration of neutropenia provide useful clues as to the nature of the fungal pneumonia in neutropenic patients. This can help better guide the choice of the initial empiric antifungal therapy and may help improve patient outcome.
Predictors of quality of life in patients with chronic obstructive pulmonary disease

Background. The predictors of quality of life (QoL) usually combine both objective disease severity and subjective individual variables. The aim of this study was to analyze the contribution of objective and subjective variables to QoL in a sample of patients with chronic obstructive pulmonary disease (COPD). Methods. 119 patients with COPD completed a QoL measure (Saint George’s Respiratory Questionnaire) and questionnaires measuring social support, personality, subjective disease-related appraisals and acceptance of life with the disease. All patients were subjected to routine physical examination, gasometric study and pulmonary function examinations. Regression analysis was computed with QoL as a dependent variable and the remaining measures as independent variables. Findings. Only one subjective (appraising the disease as an obstacle/loss) and one objective (maximal volume capacity – VCmax) variable were significant predictors of QoL, accounting for up to 24% of variance in QoL. Discussion. Out of a wide range of independent variables in this study, only two were found to explain (a portion of) variance in respiratory QoL. This urges researchers to search for other factors that affect QoL in patients with COPD.