Miracle-dz/UniFAR-FTUs huggingface dataset:
Cigarette Smoking Among Male High School Students in Rasht

Introduction: Numerous studies have indicated that more than 80% of adult current smokers started cigarette smoking before age 18 years. Early smoking initiation predicted longer duration of smoking, heavier daily consumption, and increase of chance of nicotine dependence. Objective: Determine the prevalence of cigarette smoking among male high school students in Rasht (2002). Methods and Materials: This is a cross sectional study, self– completion anonymous questionnaires were administered by 1400 male high school students. Who were selected base on a clustered sampling. The questionnaire consist of two sections, section one dealt with sociodemographic data, including; age, education, marital status, parent’s education, cigarette use among parents and other family members and section two assessed details of use of cigarette at present time. Use or disuse of cigarette, rate of daily consumption, time of the first consumption, effective factors on consumption and tendency of leave of cigarette. Data were analyzed with SPSS 9 version and χ2 test and multinomial logistic regression were used. Results: Among 1400 students 92% (1297 students) responded. The mean age of them was 16.2 ± 0.9 years (range from 14 to 18 years). 366 subjects (28.2%) were ever smokers and 195 subjects (15%) were current smokers. Among current smokers, 54.6% were irregular smokers, 45.5% were daily smokers that 24.8% were daily smokers with more than 1 cigarette per a day. Among smokers, the mean age for starting smoking was12.8 ± 2 years. In logistic regression models, cigarette use by friends and family members, history of failing in high school were associated with smoking. Conclusion: This study showed that cigarette smoking is important health problem among high school students. Its control need appropriate preventive programs in high school.
Factors correlating with prolonged fatigue among emergency department nurses

Background Fatigue affects nurses negatively and leads to physical, cognitive and emotional problems that may influence nurses' quality of life. However, there is a lack of studies about prolonged fatigue and its relationship with socio-demographic characteristics and job-related psychosocial factors among nurses, especially emergency nurses, worldwide and in Jordan. Aims This study aims to assess the relationship between demographic factors, physical health, psychological distress and job-related psychosocial factors (psychological job demands, job control and social support) and prolonged fatigue among emergency department nurses in Jordan. Methods A descriptive correlational study using a convenience sample was used to recruit 153 emergency nurses. Physical health Questionnaire, General Health Questionnaire, Job Content Questionnaire and Checklist Individual Strength were used. Results The majority of emergency nurses experienced abnormally prolonged fatigue, moderate health, high psychological distress, high job demands and low job control and social support. Significant negative relationships were addressed between job control, social support and prolonged fatigue, whereas income had a negative weak relationship. Psychological distress and job demands had a positive weak relationship with prolonged fatigue. There was a significant positive weak relationship between psychological distress, job demands and prolonged fatigue. Job-related psychosocial factors (with exception of social support) and mental health were the predictors of prolonged fatigue. Conclusions Prolonged fatigue is a multidimensional phenomenon that can be affected by several factors such as job-related psychosocial factors and psychological health. These factors should be taken into consideration when testing and developing interventions to minimise prolonged fatigue among emergency nurses.
Red blood cell alloimmunization in multitransfused hemodialysis renal patients in central Sudan

Aims: Blood transfusion is an integral part in the management of chronic renal failure (CRF). Alloimmunization is a recognized complication of red blood cell (RBC) transfusion with consequences including delayed hemolytic transfusion reactions and difficulties in getting compatible blood for future transfusion. Therefore, the current study was designed to identify the frequency of RBC alloimmunization and the specificity of alloantibodies against red cell antigen among the hemodialysis patients. Methods: A total of 301 patients (239 males and 62 females) with CRF who received more than two units of blood and matched for ABO & Rh(D) antigen were enrolled in this cross-sectional study which was carried out from December 2016 to December 2017. After detailed history through questionnaire conducted to the patients, antibody screening was done by 2-cell panel with homozygous expression of the antigens (ID-Diacell I-II-DiaMed). Positive samples were further subjected to antibody identification using commercial panels of 11 cells (ID-DiaPanel- DiaMed). Results: Out of 301 patients 239 (79.4%) were males and 62 (20.6%) were females. The prevalence of alloimmunization was 16.9% and the most alloantibody frequent was anti-C (21.3%), anti-E (16.4%), and anti-K (14.8%). The most common alloantibodies produced were against Rh system (64%). Dual and triple antibody was observed. All alloantibodies were immunoglobulin G (IgG) class except anti-M was IgG and immunoglobulin M (IgM). Conclusion: This study showed that 16.9% of the multitransfused patients with chronic kidney disease (CKD) developed alloantibodies, most of which were of the Rh phenotype. These alloantibodies may lead to allograft rejection, or even poor patient survival. Thus, we advocate that renal transplant be instituted at the earliest opportunity whenever it becomes inevitable as a modality of treatment to enhance better outcomes.
Assessment of Quality of Life in Congenital Heart Disease among Egyptian and Libyan Children

Submit Date 2019-03-26 Revise Date 2019-10-04 Accept Date 2019-10-08 ABSTRACT Background: Congenital heart diseases (CHD) is defined as a structural abnormality of the heart or intra thoracic vessels present at birth that is actually or potentially of functional significance . CHD is a lifelong disease that results from a heart defect or structural anomaly at birth. As CHD impacts the physical, nutritional, and developmental status of children health, it also may change many aspects of patients and their families' life, as social, psychological dimensions, there by impacting their quality of life. Aim of the study : This study aims to verify a possible effect of CHD on the quality of life of Egyptian and Libyan children and their families. Subjects and methods: Across sectional study was conductedamong279 children, distributed into 2 groups; 186 Egyptians, and 93Libyans, and were subjected to complete history, socioeconomic evaluation, assessment of Quality of life (QoL) of patient by pediatric cardiac quality of life inventory,and evaluation of quality of life of family by WHOQOL BREF. Results: Regarding QoL assessment in CHD patients, results showed that QoL of diseased children was affected in both groups.Bad parents’ QoLwas higher among Egyptian CHD families than Libyan families, while bad child’s QoL and bad siblings’ QoL were higher among Libyan CHD children than Egyptian CHD children. Children's bad QoLwas positively correlated to parents and siblings' QoL. Also, cyanotic CHD was associated with bad QoL. Conclusion : CHD can affect QoL. So, it is recommended to concentrate on social and psychological aspects in CHD patient through health education and group therapy.
A prospective analysis of post mastoidectomy cavity complications

Background: The main aims of surgical treatment of chronic middle ear suppuration are elimination of disease process, reconstruction of hearing mechanism and prevention of complications. The objective of this study is to find out the incidence of cavity problems after open cavity mastoidectomy. To evaluate perioperative factors involved in the causation of cavity problems.Methods: A prospective analytical study was conducted among 78 patients came for open mastoidectomy admitted in department of ENT. Each patient had a follow up upto three months at twice weekly intervals. In this study a borderline healing period of three months (12 weeks) was given for the complete epithelialisation of an open mastoid cavity. SPSS was used for analysis. Results: The incidence of postoperative cavity problems in our set up is 26.92%. Youngest patient to undergo mastoidectomy was a 4-year-old boy. The youngest patient who presented with cavity problem was of 7years. 59 (75.64%) had sclerotic mastoid and 10 (12.82%) had cellular mastoid and 9 (11.53%) had diploeic mastoid. Hence out of the 21 postoperative mastoid cavity problems, 5 cases had large postoperative cavity, 18 cases had high facial ridge, 1 case had stenosis of meatoplasty, 17 cases had exposed middle ear and eustachian tube and 17 had postoperative granulations.Conclusions: There should be complete exenteration of disease from the middle ear and mastoid. An adequately lowered facial ridge is an essential step to attain a dry cavity.
Identification of molecular markers for pre-thrombotic state: validation in the rabbits with tibia fracture or lung cancer

Background Currently there is no reports on identifying molecular markers for pre-thrombotic state in animal experimental settings. It’s necessary to explore the potential molecular markers for pre-thrombotic state to provide evidence for the pharmacotherapy of venous thromboembolism (VTE). Methods A total of 36 male rabbits were randomly divided into Sham, Tibia fracture, Lung cancer, Tibia fracture and lung cancer group. Pro-thrombin time (PT), thrombin time (TT), activated partial pro-thrombin time (APTT), fibrinogen (FIB), D-dimer (D-D) and anti-thrombin III (AT-III) at baseline, 1, 7, 14 and 21 days after operation were detected. Immuno-histochemical staining of tumor tissue sections was performed to observe the expression of CD31, VEGF and vWF. Western blot and qPCR were used to detect the expression levels of ANG and VEGF gene in tumor tissues. Furthermore, we analyzed the tumor tissue with HE staining, immunochemistry, qPCR and Western blot. all the data were statistically analyzed with GraphPad Prism 6. Results There were 0, 1, 2, 4 cases of VTE in sham, tibia fracture, lung cancer, tibia fracture and lung cancer group respectively. The level of PT, APTT, TT and AT-III were significantly decreased after operation (all P<0.05), whereas the level of FIB and D-D were significantly increased after operation (all P<0.05). The level of PT, APTT, TT and AT-III were gradually decreased in tibia fracture, lung cancer, tibia fracture and lung cancer group respectively (all P<0.05), while the level of FIB and D-D were gradually increased in tibia fracture, lung cancer, tibia fracture and lung cancer group respectively (all P<0.05). The medullary lymphocytes increased significantly in the lung cancer group, tibia fracture and lung cancer group (all P<0.05), and the number of medullary lymphocytes in tibia fracture and lung cancer group is significantly higher than that of lung cancer group (P<0.001). The expression of CD31, VEGF and vWF in Tibia fracture and lung cancer group is significantly higher than that of lung cancer group (all P<0.001). The expression ANG and VEGF in tibia fracture and lung cancer group is significantly higher than that of lung cancer group (all P<0.01). Conclusions PT, TT, APTT, FIB, D-D and AT-III seem to be sensitive molecular markers for identifying the pre-thrombotic state. CD31, VEGF, ANG and vWF play an important role in the progression of the pre-thrombotic state.
36th Bethesda Conference: Eligibility Recommendations for Competitive Athletes With Cardiovascular Abnormalities

The recommendations set forth in this report are those of the Conference participants and do not necessarily reflect the official position of the American College of Cardiology Foundation. This 36th Bethesda Conference report is the result of a consensus conference held on November 6, 2004, in New Orleans, Louisiana. Consensus conferences are designed to facilitate consideration of significant and timely issues regarding the practice of cardiovascular medicine and matters affecting patient care, research, and training for which absolute or hard data are incomplete. Appropriate organizations other than the American College of Cardiology Foundation (ACCF) are invited to send representatives to participate in the process, as appropriate to each topic. These may include physicians and health care specialists as well as representatives from industry, government, foundations , and the public sector. A report is published to highlight recommendations, along with dissenting opinion, if appropriate. The recommendations set forth in this report are those of the conference participants only and do not necessarily reflect the official position of the ACCF. The Task Force on Clinical Expert Consensus recognizes the importance of maintaining high ethical standards and avoiding conflicts of interests. Because the development of this conference report depends on the knowledge and experience of its volunteers, many of whom have relationships with industry, the policy for writing committee members' relationships must be realistic , workable, and implemented in a way that protects the integrity of the process while allowing an open and honest exchange of information. Therefore, the Task Force facilitates a process for collection of disclosure statements of all relationships of conference participants that might be perceived as real or potential conflicts of interest relevant to the conference activity and publishes this information with the conference report. Please refer to the appendix of each Task Force report for author disclosure information. The focus of this 36th Bethesda Conference is the trained athlete with an identified cardiovascular abnormality. The goal is to formally develop prudent consensus recommendations regarding the eligibility of such individuals for competition in organized sports, and to present these considerations in a readily useble format for clinicians. This document constitutes an update of the 16th (in 1985) (1) and more recent 26th (in 1994) (2) Bethesda Conferences. Once again, we have attempted to ascertain by the consensus of an expert panel which cardiovascular abnormalities (and with what degree of severity) place the competitive athlete at increased risk for sudden …
Bioengineering The Fracture Callus: Bone Repair Through Fracture Mimetics

Fracture non-union is estimated to occur in approximately 5-10% of bone fractures. Tissue engineering strategies that aim to replicate mature tissue may be unresponsive to the cues observed during the initiation of fracture repair, and as such have limited ability to integrate with the host tissues. As such, this thesis aims to develop an implant that mimics the cartilaginous callus, the initial reparative stage of the body’s response to fracture; through the development of decellularised xenogeneic hyaline cartilage in combination with skeletal (stem) cells. This thesis presents data on the optimisation of an osmotic shock based decellularisation methodology (Vac-OS) for costal cartilage. The resultant scaffolds (dcECM) were investigated for the removal of cellular content and maintenance of cartilage-specific proteins such as sulfated glycosaminoglycans. The Vac-OS methodology efficiently lowered DNA content to levels below in vivo immunological response thresholds, while eliminating the highly immunogenic and abundant alpha-gal epitope. Interestingly, immunogenic neutralisation was achieved while retaining over 80% of the sGAG content, surpassing published hyaline cartilage decellularisation methodologies. Extracellular matrix (ECM) integrity was using a novel methodology based on fluorescence lifetime imaging (FLIM) and further assessed using differential scanning calorimetry (DSC). Both FLIM and DSC indicated a lack of significant change in cartilage ECM integrity, post VacOS decellularisation. The bioactivity of the dcECM was subsequently assessed using various skeletal cell populations, indicating an inherent capacity to enhance chondrogenesis. Furthermore, post-implantation in immunocompetent mice, the dcECM promoted a regenerative response, in contrast with native costal cartilage. The dcECM was also fabricated into porous scaffolds capable of being upscale to meet clinical demands and gel coatings that enhance in vitro chondrogenesis. This thesis demonstrates the dcECM’s potential as a fracture callus mimetic. The study, therefore, concludes that these constructs could potentially enhance bone repair in cases of atrophic non-union fracture, where the failure of callus formation is a defining event.
Clinically Meaningful Use of Mental Health Apps and its Effects on Depression: Mixed Methods Study

Background User engagement is key to the effectiveness of digital mental health interventions. Considerable research has examined the clinical outcomes of overall engagement with mental health apps (eg, frequency and duration of app use). However, few studies have examined how specific app use behaviors can drive change in outcomes. Understanding the clinical outcomes of more nuanced app use could inform the design of mental health apps that are more clinically effective to users. Objective This study aimed to classify user behaviors in a suite of mental health apps and examine how different types of app use are related to depression and anxiety outcomes. We also compare the clinical outcomes of specific types of app use with those of generic app use (ie, intensity and duration of app use) to understand what aspects of app use may drive symptom improvement. Methods We conducted a secondary analysis of system use data from an 8-week randomized trial of a suite of 13 mental health apps. We categorized app use behaviors through a mixed methods analysis combining qualitative content analysis and principal component analysis. Regression analyses were used to assess the association between app use and levels of depression and anxiety at the end of treatment. Results A total of 3 distinct clusters of app use behaviors were identified: learning, goal setting, and self-tracking. Each specific behavior had varied effects on outcomes. Participants who engaged in self-tracking experienced reduced depression symptoms, and those who engaged with learning and goal setting at a moderate level (ie, not too much or not too little) also had an improvement in depression. Notably, the combination of these 3 types of behaviors, what we termed “clinically meaningful use,” accounted for roughly the same amount of variance as explained by the overall intensity of app use (ie, total number of app use sessions). This suggests that our categorization of app use behaviors succeeded in capturing app use associated with better outcomes. However, anxiety outcomes were neither associated with specific behaviors nor generic app use. Conclusions This study presents the first granular examination of user interactions with mental health apps and their effects on mental health outcomes. It has important implications for the design of mobile health interventions that aim to achieve greater user engagement and improved clinical efficacy.
Patterns of Prescription and Drug Use in Ophthalmology Out-Patient Department in a Teaching Hospital

deviation. Results: A total of 900 prescriptions were analyzed with the average number of drugs per prescription being 2.4 (0.9). The most common disorders diagnosed were refractive errors (48.3% [435/900]) followed by cataract, glaucoma and others. The frequency of drug administration and duration of treatment was recorded in 92% (828/900) and 81% (729/900) of all prescriptions respectively. Antimicrobials were most commonly prescribed (39.9% [941/2354]) followed by anti-inflammatory and anti- allergic (26% [612/2354]), anti-glaucoma medications (19.9% [470/2354]), mydriatic and cycloplegics (8.4% [198/2354]), miotics (3% [72/2354]), multivitamins (2.6% [61/2354]). Drugs were predominantly prescribed in brand name 82% (1932/2354) instead of generic name. Conclusion: The present study revealed certain lacunae in the prescribing practices of the Ophthalmologists of the institute as evidenced by low generic prescribing, inadequate information about frequency of administration and duration of therapy in many prescriptions. This can be addressed through proper sensitization of clinicians in the art of rational prescribing.
Evaluation of Intravenous immunoglobulin usage pattern in an educational hospital, a descriptive-cross sectional study, Bandar Abbas, IRAN

Introduction: The goal of DUE is to improve patients’ care. Studying the administration and utilization pattern of IVIg is an important research topic due to its significant role in the treatment and control of many disorders, high prices, and limited availability. We aimed to evaluate the pattern of IVIg use in an educational hospital. Material and methods: In this descriptive-cross sectional and retrospective study, 250 patients’ records included medical orders, nursing notes and drug chart were studied. We used FDA and UK protocol to evaluate of IVIg indications in our study. Data were analyzed using SPSS software. Results: Prescription of IVIg in our hospital adhered to FDA- approved indications and red indications of UK guideline with 64.1% and 67.6%, respectively. ITP was the most common cause of the correct prescriptions (52.7% based on FDA guideline and 50% based on UK guideline). Sepsis (15.5%), hyperbillirubinemia (10.4%), encephalitis (3.5%), and aplastic anemia (1.38%) were incorrect indications of IVIg in our study. ADRs was observed in 14.5% of patients. Discussions: Consumption of IVIg in our hospital, was more consistent with international guidelines compared with other hospitals in IRAN, of course unnecessary prescriptions cannot be ignored. We suggest to develop own national guideline and educate our prescribers to minimize irrational prescription of expensive and important medicines such as IVIg.
Breastfeeding advice for reality: Women's perspectives on primary care support in South Africa

Abstract Breastfeeding education and support are critical health worker skills. Confusion surrounding infant feeding advice linked to the HIV epidemic has reduced the confidence of health workers to support breastfeeding. High antiretroviral therapy coverage of breastfeeding women living with HIV, and an Infant Feeding policy supportive of breastfeeding, now provides an opportunity to improve breastfeeding practices. Challenges remain in restoring health worker confidence to support breastfeeding. This qualitative study presents findings from focus group discussions with mothers of young infants, exploring their experiences of health worker breastfeeding counselling and support. Analysis followed the thematic framework approach. Six researchers reviewed the transcripts, coded them independently, then jointly reviewed the codes, and agreed on a working analytical framework. Although mothers received antenatal breastfeeding messages, these appeared to focus rigidly on the importance of exclusivity. Mothers described receiving some practical support with initiation of breastfeeding after delivery, but support and advice for post‐natal breastfeeding challenges were often incorrect or absent. The support also ignored the context in which women make infant feeding decisions, including returning to work and pressures from family members. Despite improved breastfeeding policies, restoring confidence in health workers to support breastfeeding remains a challenge. The post‐natal period, when mothers experience breastfeeding difficulties, is particularly critical, and our findings reinforce the importance of continuity of care between communities and health facilities. This research has implications for how health workers are trained to support breastfeeding. Greater attention is needed on developing skills and confidence in identifying, assessing, and supporting women experiencing breastfeeding challenges.