Miracle-dz/UniFAR-FTUs huggingface dataset:
Efficacy of Helfer Skin Tapping Technique on Pain Intensity as perceived by the patients receiving Intramuscular Injection

Intramuscular injection is common procedure that nurses frequently carry out which causes pain and distress to the patient, Pain is a feeling triggered in the nervous system. Pain may be sharp or dull. Aim of the study: Â To evaluate the Efficacy of Helfer Skin Tap Technique on reducing Pain intensity Associated with Intramuscular Injection at the study setting. Methods: A quasi experimental research design was conducted at medical and surgical units at Main Mansoura University Hospital. The data were collected from purposive sample 100 patients of both sexes who correspond to inclusion criteria. Each patient was administered repeated intramuscular injections at the gluteal site. Then pain level with administration of intramuscular injection by traditional technique was compared with pain level with Helfer Skin Tapping Technique. The tools developed and used for data collection were socio-demographic characteristics and assessment of pain level with Universal Pain Assessment Tool. Results: The pain perception of patients in terms of pain level of traditional technique was found to be significantly higher than pain level of Helfer skin tapping Technique. Conclusion: Skin tapping technique was effective in reducing pain level of patients. Thus, skin tapping technique can be used as an intervention to reduce pain associated with administration of intramuscular injection.
Deploying diode laser in periodontics: An evidence-based review

Lasers have completely changed the concept of dental treatment since three and half decades of 20th century. After the invention of ruby laser by Maiman in 1960, laser has become the most magnetizing technology in dentistry. Diode Lasers have been used in initial periodontal therapy, surgery, and also in implant treatment. In many countries Laser has become a part of the dental armamentarium. The included articles were searched from PubMed, Trip Database, Google scholar and Cocharane database. The purpose of this review article is to critically analyze the effectiveness of diode laser on soft and hard tissue in the field of Periodontics.
Health professionals’ referral practice and related healthcare utilization for people with low back pain in Singapore: A retrospective study

Background: Low back pain is a common musculoskeletal disorder that can incur high financial burden. A significant proportion of this burden may be incurred from referrals to health services and subsequent healthcare usages. Patients’ overall experience of pain and its related life interferences may also have some relevance to this usage. Objective: This study aimed to examine the referral practices and subsequent health service utilization of patients with LBP within a tertiary specialist clinic setting. A secondary objective was to explore potential associations between primary independent variables of pain and life interferences with health service utilization. Methods: Participants were patients with low back pain, who completed a set of self-reported low back pain measures. These included measures for pain intensity, pain interference, disability and quality of life. The participants’ back pain-related referral and health service utilization in the subsequent 12 months were recorded. Results: A total of 282 patients completed the full measures. Of these, 59.9% were referred for physiotherapy, 26.3% for diagnostic imaging and 9.2% for interventional procedures. Compared to patients who were referred from tertiary care, those from primary care had lower pain intensity (p=0.001), pain interference (p=0.002), disability (p=0.001), but better physical and mental quality of life (p<0.001, p=0.017). High pain interference was a common factor among patients who were referred on to other services after first consultation. Levels of medical utilization and physiotherapy utilization were both associated with pain intensity (F=2.39, p=0.027 vs F=3.87, p=0.001), pain interference (F=5.56, p=0.007 vs F=4.12, 0.01) and disability (F=5.89, p=0.001 vs F=3.40, p=0.016). Regression analysis showed that the source of referral contributed to 6% of the variance in medical utilization and 3% of the variance in physiotherapy utilization. After controlling the demographic variables and referral sources, none of the independent variables added any significant variance to medical utilization. Only pain intensity contributed an additional 2% variance to physiotherapy utilization. Conclusion: Referral patterns and practices appear similar to those reported in other studies. Higher levels of pain intensity, interference, disability and quality of life appear to influence the referral to different health services and subsequent treatment utilization.
Contextual Effect of the Integrated Health Post and Other Determinants on Completeness of Basic Child Immunization: A Multilevel Analysis Evidence from Jember, East Java

Background: Every year, more than 1.4 million children worldwide die from diseases that can be prevented by immunization. Immunization is still one of the most cost-effective preventive mea­su­res to reduce mortality and morbidity among child­ren. This study aimed to analyze the influ­ence of posyandu contextual and maternal cha­rac­teristics on the provision of complete basic im­mu­ni­za­tion in children aged 12-23 months. Subjects and Method: This was an observa­tional analytic study with a cross sectional design. The study was conduct­ed at 25 integrated health posts (posyandu) in Jember, East Java, Indonesia from Sep­tem­ber to October 2019. A sample of 200 mothers who had children aged 12-23 months was selected by simple random sampling. The dependent variable was complete basic immunization. The independent variables were maternal education, maternal knowledge, parity, maternal em­ploy­ment status, family income, maternal attitude, family support, and contextual effect of pos­yandu. The data were collected by questionnaire and analyzed by a multilevel logistic regression analysis run on Stata 13. Results: Provision of complete basic immuniza­tion increased with maternal education ≥Senior high school (b= 2.99; 95% CI= 1.26 to 4.73; p= 0.001), good maternal knowledge (b= 1.93; 95% CI= 0.38 to 3.53; p= 0.018), family income ≥Rp 2,170,000 (b= 1.18; 95% CI= -0.15 to 2.50; p= 0.081), positive maternal attitude (b= 1.92; 95% CI= 0.45 to 3.39; p= 0.011), and strong family sup­port (b= 2.29; 95% CI= 0.62 to 3.96; p= 0.007). Complete basic immunization decreased with ma­ternal parity ≥3 (b= -1.35; 95% CI= -2.68 to -0.01; p= 0.048) and mother working outside the ho­me (b= -2.67; 95% CI= -4.49 to - 0.85; p= 0.004). Posyandu had contextual effect on the pro­vi­si­on of complete basic immunization in children aged 12-23 months with ICC= 23.65%. Conclusion: Provision of complete basic im­mu­nization increases with maternal education ≥Se­nior high school, good maternal knowledge, fa­mi­ly income ≥Rp 2,170,000, positive maternal at­titude, and strong family support. Complete basic immunization decreases with maternal parity ≥3 and mother working outside the home. Posyandu has contextual effect on the pro­vision of com­ple­te basic immunization in children. Keywords: basic immunization, children aged 12-23 months, integrated health post, multilevel analysis Correspondence: Revina Fiandany Erynda. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: revinaerynda@gmail.com . Mobile: 085­36­18­0003. Journal of Maternal and Child Health (2020), 5(2): 154-166 https://doi.org/10.26911/thejmch.2020. 05.02. 05
Mating Behaviour in Mulberry Silkworm, Bombyx mori (L.)

Mating is an essential behavioural social event in the life cycle of silkworm, Bombyx mori (L.) for the perpetuation of population. A number of intrinsic and extrinsic factors and events of significant importance are involved in successful mating and egg deposition by an adult silk moth which besides biochemical, physiological and environmental factors also includes attraction of reproductively competent male and female moth for mating, duration and frequency of mating, age of moth at the time of mating, reuse of male moth in the production of eggs etc. An attempt has been made in this review article to elucidate briefly the behaviour of male towards female moth after eclosion, impact of duration and frequency of mating on egg deposition and oviposition, reuse of mated male moth in the production of quality and quantity eggs etc. in the silk-worm, B. mori and its significance in silkworm seed production.
T1 Relaxation Time of Achilles Tendon at 3 Tesla with Special Reference to Relevant Clinical Score: A Preliminary Study.

PURPOSE The purpose of this study was to investigate T1 relaxation time of the human Achilles tendon, to test its short-term repeatability as well as the minimal detectable change, and to assess the extent that correlate with clinical symptoms. METHODS Twenty asymptomatic volunteers and eighteen patients with clinically and sonographically confirmed tendinopathy were scanned for ankle using a 3 Tesla (T) MR scanner. T1 maps were calculated from a variable flip angle gradient echo Ultra-short echo time sequence (VFA-GE UTE) and inversion recovery spin echo sequence (IR-SE) using a self-developed matlab algorithm in three regions of interest of Achilles Tendon (AT). Signal to Noise Ratio (SNR) between the two sequences was evaluated. INTRA-class Correlation Coefficient (ICC), Coefficient of Variation (CV) and the Least Significant Change (LSC) were calculated, to test short-term repeatability of T1. Subjects were assessed by the VISA-A clinical score. P values less than 0.005 were considered statistically significant. RESULTS Mean T1 values were 427.09 ± 53.37 ms and 528.70 ± 103.50 ms using IR-SE sequence and 575.43 ± 110.60 ms and 875.81 ± 425.77 ms with VFA-GE UTE sequence in the whole AT for volunteers and patients, respectively. T1 values showed a significant difference between volunteers and patients (P=0.001). Regional variation of T1 in healthy and tendinopathic AT were greater for VFA-GE UTE sequence than for IR-SE sequence. VFA-GE UTE sequence showed clearly higher SNR compared to IR-SE sequence. Short-term repeatability of T1 values for volunteers showed an LSC of 22% and 14% for IR-SE sequence and VFA-GE UTE sequence, respectively. For patients, LSC was 14% and 5% for IR-SE sequence and VFA-GE UTE sequence, respectively. There was no correlation between T1 and VISA-A clinical score (p>0.005). CONCLUSION VFA-GE UTE sequence used for T1 mapping calculation demonstrated short acquisition time and clearly high SNR. Results revealed that T1 relaxation time can be used as a biomarker to differentiate between healthy and pathologic Achilles tendon. However, T1 showed no correlation with the VISA-A clinical score.
A Survey of Blockchain-Based Strategies for Healthcare

Blockchain technology has been gaining visibility owing to its ability to enhance the security, reliability, and robustness of distributed systems. Several areas have benefited from research based on this technology, such as finance, remote sensing, data analysis, and healthcare. Data immutability, privacy, transparency, decentralization, and distributed ledgers are the main features that make blockchain an attractive technology. However, healthcare records that contain confidential patient data make this system very complicated because there is a risk of a privacy breach. This study aims to address research into the applications of the blockchain healthcare area. It sets out by discussing the management of medical information, as well as the sharing of medical records, image sharing, and log management. We also discuss papers that intersect with other areas, such as the Internet of Things, the management of information, tracking of drugs along their supply chain, and aspects of security and privacy. As we are aware that there are other surveys of blockchain in healthcare, we analyze and compare both the positive and negative aspects of their papers. Finally, we seek to examine the concepts of blockchain in the medical area, by assessing their benefits and drawbacks and thus giving guidance to other researchers in the area. Additionally, we summarize the methods used in healthcare per application area and show their pros and cons.
Anaesthesiologic considerations in the minimally invasive setting

Minimally invasive cardiac surgery of the mitral valve (MIMVS) has become an alternative standard of care in the majority of heart centres dedicated to valve surgery. The minimally invasive approach has gained widespread acceptance from surgeons mainly based on the superior quality of valve visibility and the avoidance of large surgical incisions. The short and mid-term results of the quality of repair and the incidence of perioperative complications are comparable or even superior to the classical open approach even in high-risk patients. From the anaesthesiologic point of view, the minimally invasive approach is more demanding and requires additional knowledge and skills compared to the classical open sternotomy approach. Therefore, a special training program and dedication of team members is required to perform these procedures with comparable low complication rates. In this review, we describe the relevant anaesthesia related topics which are part of the anaesthesia management, pre-, intra- and postoperatively.
A rare reason of psa elevation seen during intravesical bcg therapy: Granulomatous prostatitis -

Prostatitis accounts for approximately 10-14% of cases of urinary system infections admitted to urologists (1). Acute bacterial prostatitis (98-99%) is the most common type of prostatitis. Granulomatous prostatitis, which differs from chronic bacterial prostatitis, constitutes less than 1% of all prostatitis cases. Etiology is not exactly known (2). When the literature is examined, it is seen that the diagnosis of granulomatous prostatitis is often made after surgical interventions of the prostate, intravesical administration of Bacillus Calmette-Guérin (BCG) in the treatment of bladder cancer, iatrogenic interventions or prostate biopsy performed under transrectal ultrasound (TRUS) guidance in patients having prostate-specific antigen (PSA) elevation. BCG treatment may increase dysuria and irritative symptoms, especially in patients with voiding dysfunction (3). In this article, we aimed to present a case of granulomatous prostatitis who was diagnosed with bladder cancer, had PSA elevation during intravesical BCG therapy, and underwent prostate biopsy under TRUS guidance.
Association of anticardiolipin IgM antibody with preeclampsia

The objective of this study was to evaluate association of anticardiolipin IgM antibody with preeclampsia among the 70 pregnant women having preeclampsia from March 2016 to February 2017. Equal number of age matched normotensive healthy pregnant women was selected as control. Demographic, obstetric and relevant laboratory data were collected and compared between the two groups. The level of anticardiolipin IgM antibody was significantly higher in preeclamptic women than in normal pregnant (mean 8.7 vs 5.8 U/mL, p<0.001). Even in categorical distribution when the value was considered as positive by assessing a cut-off, cases had three times more chance to have positive level of anticardiolipin IgM antibody than controls (OR=3.3, 95% CI=1.1-9.6, p=0.046). Pearson’s correlation test revealed that both systolic and diastolic blood pressure had a positive correlation with the level of anticardiolipin IgM antibody. (p<0.05). In conclusion, this study shows that anticardiolipin IgM antibody was associated with preeclampsia. The level of this anticardiolipin IgM antibody is directly proportional to the severity of preeclampsia and both systolic and diastolic blood pressure.
Comparison of fluorescence optical imaging, ultrasonography and clinical examination with magnetic resonance imaging as a reference in active rheumatoid arthritis patients

Abstract Background: Fluorescence optical imaging with indocyanine-green enhancement (FOI) is a new imaging modality for the assessment of hand arthritis. The objective of this study was to compare performance profiles of clinical examination (CE), US and FOI using MRI as a reference in the same active rheumatoid arthritis (RA) patients. Methods: CE, US, FOI and MRI were performed on six subjects with active RA. Each sequence of FOI was divided into three phases based on indocyanine-green dynamics and the joints were graded semi-quantitatively. Sensitivities and specificities of CE, US and FOI were calculated using the RAMRIS synovitis score >0 as a reference in a total of 30 joints (the second to fifth metacarpophalangeal (MCP) joints and the wrist of the clinically dominant hand). Results: FOI showed sensitivities and specificities, respectively, of 85% and of 94% for Phase-1 and 69% and 94% for Phase-2. Sensitivities and specificities were 100% and 35% for CE (tender or swollen), 92% and 41% for gray scale US, and 77% and 100% for color-Doppler US. Conclusions: The performance characteristics of FOI in detection of synovitis in patients with active RA are comparable to those of US and more specific than CE. FOI has a potential as an assessment modality of RA.
Accuracy and safety of an artificial intelligent system for nonacute headache diagnosis (P3.127)

Objective: Evaluate accuracy and safety of an artificial intelligent (AI) system for nonacute headache diagnosis. Background: Headache is the main cause of neurologic consultation, entailing high cost in healthcare systems and a great impact in quality of life of patients suffering from it. Moreover, the access to qualified specialists and appropriate treatment is not ensured, especially in areas with low number of neurologist per capita. We hypothesize that and AI-system could assist in the diagnosis of headaches with a precision and safety comparable to a specialist. Design/Methods: We reviewed a database of 580 clinical records of patients with headache as chief complaint. Clinical records were processed with Latent Semantic Analysis (LSA) and a Support Vector Machine (SVM) model was trained. The definite diagnosis was the one given by the specialist at the consultation. We compared the SVM model performance at classifying the headache as primary versus secondary with two general neurologist. Finally, we used an interactive headache questionnaire filled by patients previous to the consultation and classified the headache with an automatic ICHD criteria system supplemented with a machine-learning model, comparing that diagnosis to the one given by neurologists. All the development and analysis was done using Python. Results: The SVM model trained after “reading” clinical records with LSA had a better performance in the diagnosis of secondary headache (sensitivity=90.2%; specificity=93%) in comparison with other neurologists (sensitivity=82%; specificity=85%). A correct headache diagnosis was achieved in 89–94% of the cases when ICHD criteria was combined with several machine-learning models. Conclusions: AI has a great potential for its application in headache diagnosis. Advancements in this field would both improve the accessibility to quality healthcare and optimize the time spent by health professionals. Disclosure: Dr. Acosta has nothing to disclose. Dr. Grimaldi has nothing to disclose. Dr. Dorr has nothing to disclose. Dr. Varela has nothing to disclose. Dr. Alessandro has nothing to disclose. Dr. Goicochea has nothing to disclose. Dr. Fernandez Slezak has nothing to disclose. Dr. Farez has nothing to disclose.
Strategies for non-invasive management of high-grade cervical intraepithelial neoplasia: prognostic biomarkers and immunotherapy

High-grade cervical intraepithelial neoplasia (CIN) is a precursor to cervical cancer. The surgical treatment strategy currently available increases the risk of preterm birth. This dissertation therefore examined two other treatment strategies. Because part of CIN disappears on its own, we first researched biomarkers (substances, patient characteristics) that could potentially be used for predictive purposes. Unfortunately, none of the markers we examined had any predictive value. We then researched whether imiquimod cream could serve as an alternative treatment method, which was met with enthusiasm from both gynaecologists and patients. We therefore tested the effectiveness and side effects of imiquimod cream in 120 female subjects. The results will be published soon.
Power-law correlations and coupling of active and quiet states underlie a class of complex systems with self-organization at criticality

Physical and biological systems often exhibit intermittent dynamics with bursts or avalanches (active states) characterized by power-law size and duration distributions. These emergent features are typical of systems at the critical point of continuous phase transitions, and have led to the hypothesis that such systems may self-organize at criticality, i.e. without any fine tuning of parameters. Since the introduction of the Bak-Tang-Wiesenfeld (BTW) model, the paradigm of self-organized criticality (SOC) has been very fruitful for the analysis of emergent collective behaviors in a number of systems, including the brain. Although considerable effort has been devoted in identifying and modeling scaling features of burst and avalanche statistics, dynamical aspects related to the temporal organization of bursts remain often poorly understood or controversial. Of crucial importance to understand the mechanisms responsible for emergent behaviors is the relationship between active and quiet periods, and the nature of the correlations. Here we investigate the dynamics of active (θ-bursts) and quiet states (δ-bursts) in brain activity during the sleep-wake cycle. We show the duality of power-law (θ, active phase) and exponential-like (δ, quiescent phase) duration distributions, typical of SOC, jointly emerge with power-law temporal correlations and anti-correlated coupling between active and quiet states. Importantly, we demonstrate that such temporal organization shares important similarities with earthquake dynamics, and propose that specific power-law correlations and coupling between active and quiet states are distinctive characteristics of a class of systems with self-organization at criticality.