Miracle-dz/UniFAR-FTUs huggingface dataset:
Bruising in Children: Exploring the Attitudes, Knowledge and Training of Child Protection Social Workers and the Interface with Paediatricians regarding Childhood Bruising

While child protection social workers (CPSWs) make decisions about which children with an injury need a medical examination, we do not know how they make these decisions. We aimed to ascertain the knowledge, attitudes and training of CPSWs in regards to assessing childhood bruising. Paediatricians' views on the bruising knowledge and training of CPSWs were also explored, as well as the relationship and communication between the two professions. ‘Aimed to ascertain the knowledge, attitudes and training of CPSWs in regards to assessing childhood bruising’ Semi-structured, face-to-face interviews were conducted with 39 CPSWs and 16 paediatricians across South Wales and South West England. Interviews were recorded and transcribed until data saturation was reached. Using NVivo, two independent assessors conducted a thematic analysis, identifying themes emerging from the data with group comparisons where appropriate. CPSWs lack confidence in assessing bruising with knowledge gaps regarding bruise patterns and the lack of evidence for ageing bruises. This appears to be linked to an almost complete lack of training. An important theme was that CPSWs regard the clinician's view as paramount, yet paediatricians feel that there is an over-expectation of what a child protection medical can conclude; this exemplified some of the communication issues between the professions. Evidence-based training of CPSWs is needed jointly by health and social care professionals, including an understanding of the respective roles. Copyright © 2017 John Wiley & Sons, Ltd. Key Practitioner Messages CPSWs lack confidence in assessing bruising characteristics associated with physical abuse, largely due to their lack of training. CPSWs' decisions to refer for medical examinations are strongly influenced by an exploration of history and key social factors, including chastisement strategies and the home environment. Paediatricians are unaware of CPSWs' training or knowledge, and thus have unrealistic expectations of their assessment of bruising characteristics. Communication between professionals could be improved by joint professional training in this area, providing current scientific evidence relating to bruises and an explicit explanation of the role of each in this assessment. ‘Paediatricians are unaware of CPSWs' training or knowledge, and thus have unrealistic expectations of their assessment of bruising characteristics’
Lembe Study: Left Main PCI in Belgaum

Objectives: To study left main registry for Indian population, demographic and procedural characteristic of patient outcomes after unprotected left main percutaneous coronary intervention (uLMPC) and identify the predictors of prognosis. Methods: A total of 109 consecutive patients, who underwent uLMPCI, were analyzed in this single-center registry. All data related to the patient's clinical presentation, procedure and follow-up were collected. Syntax score and medina score were calculated for all patients. Mean follow-up duration of the study was 1 year. Procedural success rate for left main intervention was 100%. Primary endpoint was composite of major adverse cardiovascular and cerebrovascular events (MACCE), including cardiac death (CD), cerebrovascular accident (CVA), myocardial infarction (MI), and need for repeat revascularization and intervention. Results: There was no primary end point noted in our study. Overall one year MACCE-free survival rate was 100%. Secondary end points were seen in 9 (8.2%). Secondary end point were lower in non diabetic patients who underwent uLMPCI with left main alone intervention, single stent in a vessel. Patients with syntax score ≤ 32 had higher event-free secondary end point rate than those with syntax score >32 . Syntax score >32 was found to be significantly correlated to prior PCI/CABG patients, patients with multiple stenting and multiple vessel stenting. Syntax score >32 was the only independent predictor of adverse outcome. Conclusion: uLMPCI is safe and effective treatment alternative to CABG in non diabetic patients with selected LM alone, single vessel and single stent patients with low and intermediate syntax score (≤ 32).
An investigation into GPs' perceptions of children's mental health problems.

BACKGROUND Mental health disorders in children are common. General practitioners (GPs) have a significant role in the detection of these disorders, yet there is lack of evidence to assess this ability. This study aimed to explore GPs' recognition of children's mental health problems, examining GPs' ability to identify both a common emotional and behavioural disorder. METHOD Between November 2014 and March 2015, an online survey-based questionnaire measure was used, composed of a series of six clinical vignettes designed to assess GPs' mental health literacy with respect to children of primary school age. This included recognition accuracy, rating of problem severity, and degree of concern about hypothetical cases, described in the vignettes. RESULTS Of the 97 participants, all identified the clinical level separation anxiety disorder and 97.9% identified the clinical level oppositional defiant disorder. Nonparametric analyses identified a significant difference (Z = -5.44, p < .0001, r = .55) in the GPs' concern for the child with clinical oppositional defiant disorder versus the concern for the child with clinical separation anxiety disorder. Participants were significantly more concerned about a boy presenting with clinical separation anxiety (Z = -7.18, p < .001, r = .72) than a girl. Also, participants were significantly more concerned about a boy presenting with clinical level oppositional defiance (Z = -7.79, p < .001, r = .79). CONCLUSION This study shows the majority of GPs can identify a primary school child with clinical level symptoms of either a common emotional or behavioural disorder described in a written vignette. However, GPs were more concerned when the child was male or displaying symptoms of a behavioural disorder.
Neurotization in Brachial Plexus Injuries

In neurotization or nerve transfer, a healthy but less valuable nerve or its proximal stump is transferred in order to reinnervate a more important sensory or motor territory that has lost its innervation through irreparable damage to its nerve. In brachial plexus injuries, extraplexal nerves such as the spinal accessory nerve, rami of the cervical plexus, or intercostal nerves are transferred onto trunks, cords, or individual nerves or else segments of the brachial plexus that maintain continuity with the spinal cord may be coapted to trunks or cords the surgeon wishes to innervate. This method is particularly indicated in root avulsion injuries that occur frequently following traction trauma to the brachial plexus. The authors convey their experience with neurotization using the long thoracic nerve in seven cases, the accessory nerve in 30 cases, intercostal nerves in 66 cases, and various nerve transfers within the plexus in 31 cases. Results of other authors are also reported. With these methods, it is possible to obtain good elbow flexion in more than one-half of patients; however, only limited shoulder function and no useful finger function are obtained.
BRIEF COMMUNICATIONS Direct Analysis of /?-Adrenergic Receptor Subtypes on Intact Adult Ventricular Myocytes of the Rat

|8iand |82-Adrenergic receptors co-exist in the adult rat ventricle. We have employed radioligand binding and cell purification techniques to determine the cellular origin of these receptors. The /3-adrenergic antagonist ligand (±)-[I]iodocyanopindolol binds to 2 X 10 receptors per purified adult rat cardiomyocyte, with a dissociation constant of 70 DM. The subtypeselective antagonists betaxolol (pi), practolol (/3i), and zinterol (&) compete for ['I]iodocyanopindolol-binding sites on intact myocytes in monophasic manners with dissociation constants of 46, 845, and 923 nM, respectively. [ I]iodocyanopindolol binding to membranes prepared from nonmyocyte elements of rat ventricle occurs with a dissociation constant of 43 pM and a capacity of 88 fmol/mg membrane protein. Computer analysis of competition of [I]iodocyanopindolol binding by betaxolol, practolol, and zinterol in nonmyocyte membranes demonstrates biphasic curves that comprise binding to both ftand ^-receptors. These data demonstrate that purified adult ventricular myocytes possess only f), -receptors, and that the 182-receptors found in rat ventricle are located on nonmyocyte cell types (Circ Res 56:126-132, 1985)
The Near Future of HCV Treatment: Supplementary Treatments against Oxidative Stress will be still useful?

It is a positive single-stranded RNA virus that gives rise to a polyprotein from which have origins: the core protein (core) and the envelope glycoproteins 1 and 2 (E1 and E2, respectively), which are constituents of the HCV particles, p7 and nonstructural protein 2 (NS2), primarily involved in HCV assembly, NS3, NS4A, NS4B, NS5A and NS5B nonstructural proteins with important roles in the polyprotein processing and HCV replication [3]. HCV infection often causes severe liver diseases, including end stage liver diseases like cirrhosis and HCC [4]. Chronically infected patients are featured by metabolic derangements, inflammation and oxidative stress (OS) [5-7]. The latter, in particular, plays a main role also in metabolic alteration and inflammation. OS occurs when the equilibrium between prooxidant sources and anti-oxidant defenses is unbalanced and the reactive oxygen species (ROS) or reactive nitrogen species (RNS) is not adequately counteracted [8]. The pro-oxidant sources are multiple but, among them, mitochondria have a special place. Mitochondria, that are the power plant of cells, are the main source of ROS production due to aerobic respiration and their high metabolic activity [9]. Unfortunately, they are the also the main targets of reactive molecules that worsening the mitochondrial functionality give rise to a vicious circle able to prompt liver damages. Mitochondria are well known targets of the HCV proteins. They, in fact, interact with these organelles promoting their dysfunctions [10].
Study of the Tissue Reaction of the Region of the Midpalatine Suture of Rats after Disjunction with Spring Anchored in Mini-Implants

Midpalatine suture disjunction is a routine procedure in the orthodontic clinic; however, the cellular events involved in the procedure have not yet been completely explained. The aim of this study was to verify the tissue events, particularly those related to osteogenic differentiation, which occur in the region of the palatal suture after disjunction, by means of histologic and immunohistochemical analyses of the following noncollagenous proteins: BSP, OCC, OPN and ONC. In this study, 10 male Wistar rats aged two months and weighing approximately 250 g were used. The animals were divided into two groups of five animals: Group I – control (mini-implant placement) and group II – experimental (placement of mini-implant and disjunction spring made of 0.60mm steel wire, with an initial load of 2N (200 grams)). After 21 days, the animals were sacrificed and histological and immunohistochemical analyses were performed for the noncollagenous proteins. The use of the spring anchored to mini-implants promoted the disjunction of the median palatal suture, with a V-shaped opening, in which the base faced the superior region (at the nasal cavity) and the vertex was in the inferior region of the oral cavity (at the palatal bone). It could be concluded that after disjunction, there was presence of osteoblasts in an osteoid matrix in the region of the median palatal suture, and the immunohistochemical expression of the noncollagenous proteins increased in all the analyzed parameters, expression being most significant for ONC.
Evaluation of YKL-40 Serum Level in Patients with Type 1 Diabetes and Its Correlation with Their Metabolic and Renal Conditions

Background: Themainindicatorof long-termglycemiccontrolintype1diabetesanditscomplicationsisglycosylatedhemoglobin (HbA1c). Considering that there are little studies on the correlation of YKL-40 with HbA1C in type 1 diabetes, we evaluated such correlation to suggest YKL-40 as both diagnostic and prognostic marker of type 1 diabetes poor control and nephropathy. Methods: 49 patients of type 1 diabetes not suﬀering from any diabetic complications during recent 5 years and 43 sex- and age-matched healthy controls participated in the study. Taking fasting blood and urine samples, we measured CBC, serum levels of YKL-40, HbA1c, creatinine, lipids, and urinary concentration of albumin and creatinine using standard laboratory methods. Results: Serumlevelof YKL-40wassigniﬁcantlyhigherintype1diabetescomparedtocontrols(P< 0.001). Therewasnosigniﬁcant correlation between such levels and HbA1c (P = 0.99) in type 1 diabetic patients. There was a strong positive correlation between YKL-40anddurationof thedisease(P< 0.001). Wefoundnosigniﬁcantcorrelationbetweenserumlevelof YKL-40andotherfactors including urine/albumin creatinine ratio (UACR), blood pressure, lipid proﬁle, and serum and urine creatinine. Conclusions: Although there was a signiﬁcant increase in serum level of YKL-40 in type 1 diabetic patients, it did not show any correlation with both metabolic and nephropathic states of diabetes.
Botulinum Toxin Injection Versus Surgical Treatment for Tennis Elbow

125 Surgical treatment is considered the last option for chronic tennis elbow. The purpose of this pilot study was to compare treatment with botulinum toxin infiltration of the wrist extensor, a less invasive method, with a surgical wrist extensor release (Hohmann operation). Forty patients were included in the prospective randomized study; one group of patients had surgery (n 20), the other group of patients was treated with botulinum toxin (n 20). The results of evaluations after 3, 6, 12, and 24 months are presented. One year after treatment 13 (65%) patients in the botulinum toxin group and 15 (75%) patients in the operative group had good to excellent results. Two years after treatment 15 patients in the botulinum toxin group (75%) had good to excellent results; four patients had been operated on after initial treatment with botulinum toxin Type A. Seventeen patients in the operative group scored good to excellent (85%) at 2 years. When analyzed with an overall scoring system, no differences were found between the two forms of treatment. Botulinum toxin infiltration, a less invasive technique, may be an alternative for surgical treatment of tennis elbow.
Management of Multidrug-Resistant Tuberculosis: Chemotherapy and Beyond

Drug resistance to Mycobacterium tuberculosis represents a manmade amplification of spontaneous bacillary chromosomal mutations. Inadequate therapy because of unsatisfactory drug supply, inappropriate prescription, and poor adherence contributes to selection of resistant strains. The most problematic form, multidrug-resistant tuberculosis (MDR-TB), is defined as disease attributable to bacillary strains that are resistant at least to isoniazid and rifampin in vitro. This can be a serious health concern because it has caused many outbreaks, including those in hospitals and prisons, especially among the human immunodeficiency virus-infected population. Directly observed treatment, shortcourse (DOTS), has distinct efficacy in ensuring a high cure rate and preventing the development of drug resistance. However, in a community with a high rate of established MDR-TB, alternative specific chemotherapy with more expensive and toxic second-line agents as well as the new antimycobacterial agents, particularly the fluoroquinolones, is also needed. Surgery, and possibly immunotherapy, in selected patients are important adjuncts to improve the success rate. Preventive therapy of MDR-TB contacts by drugs or vaccine require further exploration. In countries with a limited health care budget, prevention of development of MDR-TB by DOTS delivery as part of an effective tuberculosis control program should be top priority. Clin Pulm Med 2001;8(5):265–272
Incidence of HBV, HCV and HIV among blood donors from Peshawar KPK, Pakistan

The present study was aimed to find the prevalence of Hepatitis B, Hepatitis C and HIV (Human immune deficiency syndrome) in the blood donors of Peshawar KPK during the period April 2016April 2017. A total of 3679 blood donor’s samples were screened through ELISA kit (ARCHITECT i1000SR automated immunoassay analyzer Chemiluminescent Microparticle Immunoassay). In total 3679 blood donors, HBV prevalence was higher 1.4% (54/3679), followed by HCV 0.60% (22/3679) and HIV 0.10% (4/3679). The study also revealed the distribution pattern of HBV, HCV and HIV among the blood groups of reactive samples. Blood group O+ has the highest frequency (HBV 29.6% (16/54), HCV 31.81% (7/22), and HIV 50% (2/4), followed by A+ (HBV 25% (14/54), HCV 18.18% (4/22) and HIV 25% (1/4) and B+ had 24% (13/54), HCV 22.72% (5/22). These data results suggests modest rate of incidence but more broad seroprevalance studies of the general population are needed to determine the accurate prevalence.
The thoracic boundaries

The boundaries of the canine and feline thoracic cavity consist of the thoracic skeleton, the cranial and caudal thoracic apertures and the covering soft tissue structures. The rib cage is covered by thoracic, pectoral, spinal and other musculature, subcutaneous fat and skin, and serves as an attachment for the thoracic extremities. The chapter considers Radiographic anatomy; Interpretive principles; Diseases of the thoracic skeleton; Diseases of the thoracic inlet; Diseases of the diaphragm.
A Randomized Experiment Using Absenteeism Information to "Nudge" Attendance. REL 2017-252.

This randomized controlled trial, conducted in collaboration with the School District of Philadelphia, finds that a single postcard that encouraged guardians to improve their student’s attendance reduced absences by roughly 2.4 percent. Guardians received one of two types of message: one encouraging guardians to improve their student’s attendance or one encouraging guardians to improve their student’s attendance that also included specific information about the student’s attendance history. There was no statistically significant difference in absences between students according to which message their guardians received. The effect of the postcard did not differ between students in grades 1–8 and students in grades 9–12.
TUDY ON CONVENTIONAL AND NOVEL CARDIAC BIOMARKERS IN ACUTE MYOCARDIAL INFARCTION

ABSTRACT Objective: Employment of the serum cardiac markers rather than noninvasive or invasive procedures in the right time for accurate diagnosis of acute myocardial infarction (AMI) is a more important to restore the patient, but using all of them is inappropriate and expensive. Therefore, this study is designed to determine promising marker for the diagnosis of AMI. Methods: A total of 33 healthy volunteers and 42 AMI patients were enrolled, and the serial blood samples were obtained from the AMI patients at admission, 6 th , 12 th , 24 th , and 48 hr from the time of onset. The diagnostic efficiency was determined for creatine kinase (CK), CK MB (CK-MB), N-terminal fragment of B-type natriuretic peptide (NTproBNP), high sensitive cardiac troponin I (hscTnI), ischemia modified albumin (IMA), heart-type fatty acid binding protein (H-FABP), and myoglobin using receiving operating characteristic (ROC) curves and compared for time periods. th Results: Lipid profile, fasting blood sugar (FBS), creatinine, alanine transaminase (ALT), and aspartate transaminase (AST) were significantly higher in AMI when compared to control. In the early stages of AMI, the ROC of H-FABP (0.89; 95% confidence interval [CI], 0.72-0.82), IMA (0.83; 95% CI, 0.74-0.90), hscTnI (0.81; 95% CI, 0.75-0.92), NTproBNP (0.82; 95% CI, 0.72-0.89) and myoglobin (0.86; 95% CI, 0.76-0.93), and displayed good diagnostic efficacy (p<0.0001). Conclusion: Within 2-6 hrs from onset of the symptoms, H-FABP, IMA and Myoglobin showed good diagnostic ability and in the entire episode, hscTnI holds its superiority in the diagnosis of AMI. Keywords: Acute myocardial infarction, Serum cardiac markers, Serial sampling, Diagnostic ability.
Determination of swine euthanasia criteria and analysis of barriers to euthanasia in the United States using expert opinion

Timely euthanasia on swine farms can help to reduce the incidence of poor welfare outcomes for compromised pigs (Sus scrofa) when recovery is prolonged or impossible. Timely euthanasia relies upon caretakers’ abilities to identify compromised pigs and administer euthanasia in various environments. To determine appropriate timelines and most common reasons for on-farm euthanasia, an online survey was conducted with members of the United States National Pork Board. Additionally, two focus groups were conducted to investigate barriers and possible solutions associated with timely euthanasia. Clinical signs related to poor locomotion (57.6%), prolapses (47.2%), and hernias (43.5%) were identified by the greatest percentage of respondents who believed immediate euthanasia was warranted, while a greater percentage of respondents believed euthanasia was not warranted for clinical signs related to the integumentary (90.3%), reproductive (75.8%), and respiratory (67.5%) systems. The most common reason for euthanasia was poor body condition in pre-weaned piglets and non-ambulatory or severely weak for both breeding and non-breeding pigs. In the focus groups, two themes were identified when evaluating barriers to euthanasia on-farm, and participants agreed that making timely decisions relies upon several dimensions of risk analysis. An unsupportive farm culture was identified as a critical barrier to timely euthanasia decision-making, suggesting that caretaker characteristics may play a role in the success of any timely euthanasia programme. This present study has highlighted areas for future research and demonstrated the need to extend educational efforts both to swine industry leaders and producers to improve overall animal welfare by ensuring timely euthanasia in swine.
Clinical Relevance of Calcaneal Bone Cysts

The clinical relevance and nature of calcaneal cysts is controversial. The risk of pathologic fracture is undefined and diagnostic criteria to differentiate between cysts in patients who can be treated nonoperatively and patients who require surgical intervention are not available. To address these questions, 50 calcaneal bone cysts in 47 patients were evaluated. The majority of cysts (40 of 50) were asymptomatic and were treated nonoperatively. Cysts reaching a critical size, defined as 100% intracalcaneal cross section in the coronary plane and at least 30% in the sagittal plane, are at risk for becoming symptomatic and at risk for fracture. Fracture is a significant complication and occurred in four of 47 patients, three of whom were treated by open reduction internal fixation and bone grafting. In addition, six patients with symptomatic critical size cysts without apparent fracture were treated by curettage and subsequent autogenous bone grafting or calcium-phosphate cement filling, and there were no recurrences. We report one of the largest series of cysts in the calcaneus. The results suggest that calcaneal cysts are clinically relevant because of the potential risk of fracture and that size is a significant factor in terms of the treatment of the cyst.