Miracle-dz/UniFAR-FTUs huggingface dataset:
The effects of exercise in the rehabilitation process of substance abuse

The Effects of Exercise in the Rehabilitation Process of Substance Abuse by Gabriela Vilarino Regino Dr. Gabriele Wulf, Examination Committee Chair Professor of Kinesiology University of Nevada, Las Vegas Exercise may assist in the rehabilitation process by providing a way for the dependent individual to achieve a mild, pleasurable state that does not require the use of substances. Women between 18 and 43 years of age who were under supervision in a rehabilitation facility for substance abuse were randomly selected to be part of an exercise or a control group. They exercised three times a week for a total of two months. Subjects completed pre and post assessments of anxiety, depression, and readiness to change. They also completed pre and post assessments of resting heart rate, percent body fat, 1 minute curl up, sit-and-reach, and 3 minute step test. Post BDI-II, and BAI showed a significant difference between groups. Only post curl up, 3 minute step test, and percent body fat were significant. TABLE OF CONTENTS ABSTRACT. iii LIST OF FIGURES. vi LIST OF TABLES.vii ACKNOWLEDGEMENTS. viii CHAPTER
Hepato-Renal Toxicity Following Administration of Hippocratea africana Ethanolic Leaf Extract

Hippocratea africana (HA) extract has been widely reported for its anti-plasmodial and antioxidant activites. This study was designed to investigate the plants’ ethanolic leaf extract on the liver and renal functions, and histology in experimental animal model. Fifteen female adult Wistar rats weighing 150 - 160 g were divided into 3 groups (A - C) of 5 rats each. Group A, the normal control received distilled water 4 ml/ kg body weight, groups B and C received HA extract (524.4 and 786.6 mg/kg body weights respectively); representing 20% and 30% of LD50 which was 2622.2 mg/kg body weight. Extract administration was by orogavage for 28 days, and serum was collected for renal and kidney function tests using standard procedures. Liver and kidney were excised, fixed in 10% formal saline, processed and stained with H&E, and Masson’s trichrome stains for light microscopy. Signs of behavioural toxicity or mortality were not observed during the experiment, however, mild to moderate morphological alterations were demonstrated in both the liver and kidney of test animals with the widening of the urinary space, atrophy of the glomerulus, foci hyperplasia, and tubular swelling of the kidney in groups B and C animals, and this was corroborated in the liver, where there was mild to moderate widening of sinusoidal spaces with some presence of fatty changes. The liver function test indicated increasing serum enzymes of which alkaline phosphatase was significantly (p < 0.05) increased in groups B and C, whereas renal function test were significantly (p < 0.05) increased in these groups particularly of serum creatinine and urea. In conclusion, increasing doses and duration of HA administration may lead to severe hepato-renal complications.
Cost‐consequence analysis evaluating multifaceted clinical pharmacist intervention targeting patient transitions of care from hospital to primary care

Drug‐related problems are a common complication in the transition from hospital to primary care and are associated with morbidity and increased health care costs. In this study, we evaluated the cost and consequences of a comprehensive pharmaceutical intervention compared with usual care, comprised of a medication review and patient interview before discharge and follow‐up for polypharmacy patients.
Maternal Understanding Regarding Women Nutrition during Breastfeeding

Introduction: Breastfeeding mothers’ nutritional status affects milk quality and children’s nutrition in a key period for life. Objectives: Identifying and describing breastfeeding mothers’ social representations during this period related with nutrition as self-care; connotations referred to food products and supplements; post-partum weight retention and information sources consulted on this matter. Materials and Methods: Ten in depth interviews were performed in healthy adult breastfeeding mothers. Interviews were analyzed with a qualitative methodology considering Health Beliefs, PRECEDE and Health Promotion models, employing the Grounded Theory. Results: Women consider nutrition as a health conditioning factor and refer dietary changes implementation during pregnancy, which are not always kept during breastfeeding. Disorganization was mentioned regarding feeding and commensality, prioritizing their child’s health over their own. Vegetables and liquids are attributed to positive connotations, referring increased consumption. Certain foods are limited as they are considered less healthy (“junk food”, sweets, sodas, cookies, spices, coffee and mate) while others, like milk, have been associated with negative effects. Insufficient weight gain during pregnancy is valorized as an achievement due to pairs approval and appearance. Association between breastfeeding and previous weight recovery is weak and doubted. Lack of information on feeding and breastfeeding even among health professionals is recognized. In case of doubts, mothers follow the closest belief affectively. Conclusions: Identifying and characterizing beliefs and barriers for maternal eating practices allow including socio-cultural aspects both in the design of public health policies and in individual nutritional counseling.
Can physical activity and dietary interventions improve maternal and fetal outcomes in women with gestational diabetes mellitus? A systematic review and meta-analysis

Objective. To assess the effect of increasing physical activity or modifying diet on maternal and fetal outcomes for women with gestational diabetes mellitus. Methods. Five electronic databases and Google Scholar were searched to identify randomised controlled trials (RCTs) of physical activity or diet interventions, published before August 2017. Interventions were included if participants had gestational diabetes, there was a control/comparison group and at least one outcome of interest was reported: insulin use, caesarean section or birth weight. Findings. Twenty-one studies (1613 participants) were included in the systematic review, 14 were diet and seven were physical activity interventions. Diet types included low glycaemic, energy restricted and dietary approaches to stop hypertension (DASH). Physical activity included brisk walking, resistance training and home-based cycling. Meta-analysis of 17/21 RCTs suggested physical activity reduced insulin use by 47% (OR 0.53, 95% CI 0.29,0.97, P=0.04) and the DASH diet reduced insulin use by 89% (OR 0.11, (95% CI 0.04, 0.29, P<0.00001). Neither physical activity or combined diet interventions reduced the number of caesarean sections and only the diet interventions reduced birth weight -289.80g (95% CI -526.87, -52.72, I2=98%). The DASH intervention produced statistically significant results across all three outcomes. In the meta-analysis, 15/17 studies scored a highrisk of bias on at least one domain. Conclusions. Physical activity interventions can reduce insulin use and diet interventions can reduce birth weight in women with gestational diabetes. Further intervention studies are needed that are theoretically underpinned and provide social support as these elements were lacking in the included studies.
Etiology and pathogenicity of bacterial isolates: a cross sectional study among diarrheal children below five years in central regions of Kenya

Introduction Bacterial agents are among pathogens implicated to cause diarrhea in children resulting to huge mortality and morbidities. Bacterial etiologies causing diarrhea in children below five years are rarely investigated in Central Kenya, which would otherwise guide prescription and target health education. Methods A cross-sectional study approach was applied on 163 randomly selected stool samples from children below five years who presented with diarrhea in Murang`a and Muriranja`s hospitals. The objective was to determine the bacterial agents of diarrhea. Enteric bacterial pathogens were cultured using appropriate media and identified. Statistical analyses were performed using STATA v.13. Chi-square or Fisher exact-test were used to check for evidence of relationship whenever applicable. Results There were nearly equal distributions in gender 86 (52.8%) female vs. 77 (47.2%) male, majority (35.6%) aged between 0-12 months. Bacterial isolates were highly diverse in female than the male, children aged 49-60 months and least among those aged 0-12 months. A total of 188 bacterial isolates belonging to 11 genera were recovered. The predominant bacteria was nonpathogenic Escherichia coli 85 (45.2%), while 13 (6.9%) Escherichia coli were positive for virulence genes, including 8 (4.3%) positive for LT and STp Shiga-like or Enterotoxigenic Escherichia coli, 3 (1.6%) positive for eae and bfpA Enteropathogenic Escherichia coli and 2 (1.1%) positive for Enteroaggregative Escherichia coli gene. Others included: Salmonella 21 (11.2%), Pseudomonas 14 (7.4%), Shigella 14 (7.4%), Klebsiella 12 (6.4%), Aeromonas 8 (4.3%), Enterobacter 7 (3.7%), Proteus 8 (4.3%), Citrobactor 3 (1.6%), Yersinia 2 (1.1%) and Vibrio 1 (0.5%). Conclusion Salmonella was the major bacterial isolate and majority of the bacteria were statistically significant cause of diarrhea (p=0.001).
Diagnostic accuracy of colour Doppler ultrasonography in evaluation of cervical lymph nodes in oral cancer patients

This study was conducted in the Department of Oral Medicine and Radiology, Tamil Nadu Government Dental College and Hospital, Chennai-3; Barnard Institute of Radiology, Madras Medical College, Chennai-3; Goschen Institute of Pathology, Madras Medical College, Chennai-3.Study comprised 80 Adult Subjects with clinically and histopathologically diagnosed Oral cancer of either gender with age range of 20-60 years. To avoid over-diagnosis of lymph nodes in patients with oral cancer, study was divided in two groups based on clinical criteria. Group-I included 40 patients with clinically suspected Metastatic cervical lymph nodes, Group-II included 40 patients with clinically suspected Reactive Cervical lymph nodes. In summary our study support the fact that each node involved in patient with oral cancer should not be considered as metastatic, which can lead to unnecessarily treatment of neck. Our study also showed that risk of metastasis is more in oral cancer patient with advance staging (T4 in 58.75% patients) as well as in patient with bone involvement. In this study we found that most commonly involved cervical lymph nodes in patients with oral cancer are Level (85.4%) followed by Level II (10.7%) and Level III (3.9%). Bilateral lymph node was more common with oral cancer involving tongue followed by alveolus. Cervical lymph node involvement is a single most important factor in treatment and prognosis in patient with oral cancer, as regional metastasis decreases the survival rate significantly. So there is need to evaluate the neck thoroughly for any lymph node involvement in oral cancer patients which is not possible clinically (sensitivity=79.8%, specificity=100%, accuracy=84.8%) as our study have shown. CDUS being a non-invasive, real-time procedure and easily applicable tool for the detection of alterations in the vasculature of lymph nodes may reduce the patient morbidity and therefore is of great clinical importance. In our study all of the findings suggested superiority of CDUS over clinical evaluation. In CDUS evaluation, flow pattern (sensitivity = 94.1%, specificity = 100%, accuracy = 95.4%) is more accurate than the vascular indices (sensitivity = 81.4%, specificity = 100%, accuracy = 85.5%) in differentiating metastatic from reactive lymph nodes in oral cancer patients. From our study we conclude that CDUS plays a definitive role as an adjunct to clinical evaluation of differentiating metastatic from reactive cervical lymph involvement in patients with oral cancer as it aid in grading and staging of oral cancer and can determine the treatment plan prognosis and morbidity by diminishing the possibility nodal dissection. However, results of our study on diagnostic accuracy of Colour Doppler ultrasonography in evaluation of cervical lymph nodes in oral cancer patients can be validated with more studies involving large number of oral cancer patients.
Evidence-based medicine and precision medicine: Complementary approaches to clinical decision-making

Abstract Evidence-based medicine is widely promoted for decision-making in health care and is associated with improved patient outcomes. Critics have suggested that evidence-based medicine focuses primarily on groups of patients rather than individuals, but often fail to consider subgroup analyses, N-of-1 trials, and the incorporation of patient values and preferences. Precision medicine has been promoted as an approach to individualize diagnosis and treatment of diseases through genetic, biomarker, phenotypic, and psychosocial characteristics. However, there are often high costs associated with personalized medicine, and high-quality evidence is lacking for effectiveness in many applications. For the potential of personalized medicine to be realized, it must adhere to the principles of evidence-based medicine: (1) evidence in isolation is not sufficient to make clinical decisions—patient’s values and preferences as well as resource implications must be considered, and (2) there is a hierarchy of evidence to guide clinical decision-making and studies at lower risk of bias are likely to provide more trustworthy findings.
Markers of Fibrinolysis in Indian Patients with Isolated Head Trauma

Context: Head injury causes disseminated intravascular coagulation as the most severe complication which is associated with high mortality. Elevated levels of markers of fibrinolysis such as D-dimer and fibrinopeptide A (FPA) have been correlated with poor outcome in these patients. Aim: The study aimed to correlate the levels of plasma fibrinogen, D-dimer, and FPA with outcome in patients with isolated head trauma. Settings and Design: This cross-sectional descriptive study was conducted in the Departments of Pathology and Neurosurgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, on 100 patients admitted within 12 h of isolated head trauma. Subjects and Methods: Plasma fibrinogen, D-dimer, and FPA were measured in 100 patients admitted within 12 h of isolated head trauma. While plasma fibrinogen and D-dimer were estimated in all patients, FPA was measured in 45 patients. Statistical Analysis: SPSS (20.2) software was used for mean, standard deviation, and median values of the quantitative parameters, and for all qualitative parameters, their frequencies were obtained. P < 0.05 was considered significant. Results: Elevated D-dimer (>250 ng/ml) and FPA (>3 ng/ml) were observed in 64% and 91.1% patients, respectively. Both D-dimer and FPA were elevated in 66.6% of patients. Disseminated intravascular coagulation (DIC) score, calculated using standard criteria, was ≥5 in 28% of patients indicating overt DIC. Hypofibrinogenemia was observed in 48% of patients. D-dimer, FPA, and DIC score was significantly (P < 0.001) higher and plasma fibrinogen significantly (P < 0.001) lower in nonsurvivors as compared to survivors. Elevated D-dimer and FPA and low fibrinogen levels were seen in patients irrespective of severity of injury. Conclusions: Elevated D-dimer and FPA were frequently observed in patients with isolated head trauma. As these markers rise soon after injury and indicate poor outcome, their measurement will help identify patients who will benefit with additional therapy, thus reducing morbidity and mortality.
Isolation of Different Species of Candida in Patients with Vulvovaginal Candidiasis from Damavand, Iran

Background: One of the most common infections in women, especially during the reproductive age, is vulvovaginal candidiasis, which can cause physical and psychological distress for patients. According to different reports, Candida albicans is the main etiological agent of this infection. However, non-Candida albicans species have arisen recently. Therefore, it seems that in VVC, the pattern of Candida species, have changed. Objectives: In the current study, the researchers determined the frequency of different species of Candida in the Iranian female population. Methods: Five hundred and fifty-nine patients suspected of VVC, participated in this study. Wet swabs were used for collecting the samples. Vaginal swabs were examined microscopically and treated for fungal culture. Candida species identification was done by polymerase chain reaction (PCR)-Sequencing with universal fungal primers (ITS1 and ITS4). Results: Out of 559 patients, 46 (8.2%) samples were positive for VVC. The age group of 30 to 39 years old with 20 (44.7%) patients had the highest frequency. Itching concomitant with abnormal discharge and vaginal irritation (59.6%) were the most prevalent symptoms in the patients. The most frequent identified species of Candida were Candida albicans (67.7%), Candida glabrata (25.8%), and Candida kefyr (3.2%), respectively. In addition, only one (2.1%) case showed recurrent vulvovaginal candidiasis (RVVC). Conclusions: The results of the present study demonstrated that in patients with VVC, Candida albicans species are more frequent than other candida species. In order to achieve appropriate treatment, clinical and laboratory findings must be considered together.
Sensory and behavioural responses of the malaria mosquito Anopheles gambiae to human odours

Behavioural and electrophysiological responses of Anopheles gambiae Giles sensu stricto (Diptera: Culicidae) to human skin emanations collected on glass beads were studied using a dual-port olfactometer and electroantannography. Glass beads to which skin emanations from human hands had been transferred elicited a level of attraction similar to a human hand. The attractiveness of these handled glass beads faded away four hours after transfer onto the beads. Storage at -20°C for up to eight weeks showed a decreased but still attractive effect of the beads. In a choice test between one individual and 4 others, the emanations from the reference individual were significantly more attractive in 3 out of 4 cases. The headspace of handled glass beads elicited a dose-dependent EAG response. The substances _________________________________________________________________________________________ published as: Qiu, Y.T. , Smallegange, R.C. , Hoppe, S. , van Loon, J.J.A. , Bakker, E. -J. & Takken, W. 2004. Behavioual and electropysiological responses of teh malaria vector mosquito Anopheles gambiae to human skin enamations. Medical and Veterinary Entomology, 18, 429-438. Qiu, Y.T. , Smallegange, R.C. , Hoppe, S. , van Loon, J.J.A. , Bakker, E. -J. & Takken, W
Educating health professionals in ultrasound guided peripheral intravenous cannulation: A systematic review of teaching methods, competence assessment, and patient outcomes

Background: Peripheral intravenous cannula insertion is the most common invasive healthcare procedure, however failure rates remain unacceptably high, particularly in patients with difficult intravascular access. This leads to treatment delays and increased complication risk, causing poorer outcomes among this patient subset. Ultrasonographic guidance reduces these risks and is therefore becoming a competency required of health professionals. However, there is no consensus on how to design teaching sessions to achieve this competency. Methods: Systematic review was conducted to identify characteristics of effective teaching sessions for current and training health professions to achieve ultrasound guided peripheral intravenous cannulation competency. Secondary outcomes included defining competency and to assess benefits to patients and healthcare systems. Eligibility for inclusion required description of teaching of ultrasound guided peripheral intravenous cannulation to qualified or training health professionals who went on to perform it in human patients or volunteers with reported outcomes or success rates. Studies were excluded if not accessible in full, not peer-reviewed or presented research that had been presented elsewhere previously. Of the 1085 records identified on review of 6 databases, 35 were included for final review based on eligibility criteria. Results: Almost all (97.1%) used mixed modality teaching comprising of didactic and simulation portions, although time allocated varied widely. A median of 5 proctored procedures was required for competency. Competency was independent of previous experience or staff seniority. Mean reported insertion attempts was 1.7, success rate was 82.5% and first-time success rate was 75.5%. All included studies described improvement in their participants or healthcare system including significantly reduced midline insertion rates, central venous catheter insertion rates and associated bacteremia and sepsis, self-reported cannulation difficulty, specialist input, therapy delays and premature catheter failure rates. Further, there was significantly improved procedural confidence, knowledge and competence. Conclusion: Simple teaching interventions can lead to competent ultrasound guided peripheral intravenous cannula insertion by novices, resulting in numerous positive outcomes for patients and healthcare systems.
Variabilidad genética aloenzimática en Dacus oleae (Gmelin). (Diptera: Tephritidae). I. Análisis de dos poblaciones naturales del Sureste Español

OCHANDO, M. D. ; CALLEJAS, C ; FERNANDEZ, O. H. y REYES, A. , 1994: Allozymic genetic variability in Dacus oleae (Gmelin). (Diptera: Tephritidae). I. Analysis of two natural populations from the South-east of Spain. Bol. San. Veg. Plagas, 20(1): 35-44. Genetic variation in the olive fruit fly Dacus oleae, was analyzed at 12 enzyme genes by starch gei electrophoresis. Two natural populations from the South-east of Spain were studied. The populations showed high levels of genetic variability. Average heterozygosity was 0.1339. The proportion of polymorphyc loci was 0.7725 or 0.9545 (criterion 95 % and criterion 99 % respectively). The average number of alieles per locus was 2.6818. Concerning the pattern of the variation, the most remarkable finding was the similarity of the configuration of allelic frequencies in our populations. Our observations support the conclusion that selection may be the major factor responsible for the genetic variation observed in Dacus oleae.
Development of a step counting algorithm using the ambulatory tibia load analysis system for tibia fracture patients

Introduction: Ambulation can be used to monitor the healing of lower extremity fractures. However, the ambulatory behavior of tibia fracture patients remains unknown due to an inability to continuously quantify ambulation outside of the clinic. The goal of this study was to design and validate an algorithm to assess ambulation in tibia fracture patients using the ambulatory tibial load analysis system during recovery, outside of the clinic. Methods Data were collected from a cyclic tester, 14 healthy volunteers performing a 2-min walk test on the treadmill, and 10 tibia fracture patients who wore the ambulatory tibial load analysis system during recovery. Results The algorithm accurately detected 2000/2000 steps from simulated ambulatory data. During the 2-min walk test, step counts derived from the algorithm and treadmill showed a strong correlation (r 2 >0.98) to the visual (“actual”) step count. Applying the algorithm to continuous data from tibia fracture patients revealed qualitative differences in gait between the initial and later stages of recovery. Additionally, a relatively large standard deviation (≤3000 steps) in the daily average step count indicated a variety of patient ambulatory behaviors. Conclusion The algorithm reported in this study can assess the ambulatory activity of tibia fracture patients during the recovery period.