Miracle-dz/UniFAR-FTUs huggingface dataset:
Role of ultrasonography in the diagnosis of gall-bladder carcinoma: A boon for low-resource settings

Abstract Purpose: The present study was done with an aim to evaluate the usefulness of ultrasonography (USG) in early diagnosis of gall-bladder carcinoma for low-resource settings. Materials and Methods: A total of 264 clinically suspicious cases were enrolled in the study. The patients underwent USG followed by computed tomography (CT). Histopathological specimens were obtained from 208 cases. Final diagnosis was confirmed histopathologically/CT. Sensitivity, specificity, positive predictive, and negative predictive values of USG were calculated. Results: A total of 29 cases were confirmed as gall-bladder carcinoma, 58.6% were diagnosed at advanced stage (Stage III/IV). USG diagnosed 42 cases as neoplastic, however, 24 were true positive and 18 were false positive. USG was 82.8% sensitive and 92.5% specific. The positive and negative predictive values were 57.1% and 97.8%, respectively, diagnostic efficacy was 91.5%. 94.1% advanced stage gall bladder cancers were diagnosed correctly by USG. Sensitivity for early stages was promising (61.9%), however false positive was higher. Cost of USG was nearly five times lesser as compared to that of CT. Conclusion: USG was a useful economical imaging modality for the screening of gall bladder cancer in low-resource settings, especially for advanced stages. However, for early stages too, it seemed useful. We recommend to encourage the use of USG in early detection of gall-bladder carcinoma in socially and economically disadvantaged settings.
EVALUATION OF THE LEVEL OF SATISFACTION OF HOSPITALIZED PUERPERAL WOMAN IN A MATERNITY IN THE COUNTRYSIDE OF PARAÍBA

There is now a growing need for improvement in health services provided in all health institutions. One possible strategy with this aim is to identify factors that may directly interfere with the quality of care and, therefore, determine the satisfaction of the user of this service . The purpose of this study was to evaluate the level of satisfaction of postpartum women admitted to a maternity ward, taking into account the existing structure and services provided by the institution. This is an exploratory, descriptive research of quantitative nature developed at the Deodato Cartaxo maternity hospital, belonging to the Regional Hospital of Cajazeiras, located in the municipality of Cajazeiras, Paraiba State in Brazil. The population was composed of hospitalized puerperal women and the sample of 100 woman was performed for convenience, systematic of the proportional type with a sample error of 5%. The data collection period was between the months of august and september 2015. The instrument of data collection was SERVQUAL, evaluating its five quality indicators (tangibility, reliability, attendance, safety and empathy). The results were presented in table form with their respective absolute and relative frequencies. Among the indicators studied, reliability, care and security were the ones that generated the most satisfaction among the puerperal woman and tangibility was referred to as an indicator of dissatisfaction among the users. Keywords: Evaluation of health services; consumer satisfaction; maternities.
Colistin Use Patterns and Toxicity in Critically Ill Patients in Pauls Stradiņš Clinical University Hospital

Abstract Colistin is used systemically in critically ill patients for treatment of infections caused by multi-drug resistant (MDR) Gram-negative bacteria, e.g., Acinetobacter baumanii. It is potentially nephro- and neurotoxic. It is recommended to decrease the dose of colistin in case of renal impairment or renal replacement therapies (RRT) but clear recommendations are not available yet. The aim of this retrospective study was to determine colistin use patterns in critically ill patients in Pauls Stradiņš University Hospital. Forty patients were included in this study. The most common indications for colistin were pneumonia associated with mechanical ventilation or sepsis caused by MDR A. baumanii. Median duration of colistin therapy was 11.5 (IQR 7.0; 17.0) days and median cumulative dose was 91.5 (43.0; 150.0) million units (MU). The usual regimen was 9 MU as loading dose and 3 MU three times daily as maintenance dose, but in case of renal impairment and RRT colistin regimens varied a lot between the patients. In 21% (7 from 33) of cases, acute kidney injury (AKI) was observed during colistin therapy (serum creatinine increases more than twice from baseline). All these AKI cases occurred in patients with previously normal renal function and none of the patients in this group needed RRT.
Determinants of the Median Nerve Cross Sectional Area in Rheumatoid Arthritis Patients

BACKGROUND: Rheumatoid arthritis (RA) is a widely recognized cause of carpal tunnel syndrome (CTS). Others stated that CTS is overestimated in RA. CTS is associated with increase in the thickness of the median nerve. This study aims to establish the determinants of the median nerve cross sectional area (MNCSA) in RA patients with no CTS. METHODS: Ultrasound measurements were performed in 120 RA patients (240 hands)without symptoms or diagnosis/previous diagnosis of CTS. Eachmedian nerve was measured three times, and the mean value was used for analyses. RESULTS: MNCSA was 9.79plusmn2. 6 mm2 (range 1.5-22.25). MNCSA was positively associated with the age of participants (p=0.03, CI:0.00-0.08), body mass index (BMI) (p=0.04, CI:0.00-0.21), uric acid level (p=0.033, CI:0.00-0.01), and urine microalbumin (p=0.04, CI:0.00-0.01). RA clinical characteristics and inflammatory markers showed no significant relation to the MNCSA. CONCLUSION:MNCSA in RA is affected by age, BMI, serum uric acid and microalbumin level.
Functional Characterization of Bacteria Isolated from Ancient Arctic Soil Exposes Diverse Resistance Mechanisms to Modern Antibiotics

Using functional metagenomics to study the resistomes of bacterial communities isolated from different layers of the Canadian high Arctic permafrost, we show that microbial communities harbored diverse resistance mechanisms at least 5,000 years ago. Among bacteria sampled from the ancient layers of a permafrost core, we isolated eight genes conferring clinical levels of resistance against aminoglycoside, β-lactam and tetracycline antibiotics that are naturally produced by microorganisms. Among these resistance genes, four also conferred resistance against amikacin, a modern semi-synthetic antibiotic that does not naturally occur in microorganisms. In bacteria sampled from the overlaying active layer, we isolated ten different genes conferring resistance to all six antibiotics tested in this study, including aminoglycoside, β-lactam and tetracycline variants that are naturally produced by microorganisms as well as semi-synthetic variants produced in the laboratory. On average, we found that resistance genes found in permafrost bacteria conferred lower levels of resistance against clinically relevant antibiotics than resistance genes sampled from the active layer. Our results demonstrate that antibiotic resistance genes were functionally diverse prior to the anthropogenic use of antibiotics, contributing to the evolution of natural reservoirs of resistance genes.
Epidemiology and risk factors for illness in athletes participating in sport tournaments or competitions - a specific focus on Rugby Union

11 Chapter 1: Introduction and scope of the thesis 13 Chapter 2: A review of the epidemiology and risk factors for illnesses in athletes participating in sport tournaments or competitions a specific focus on Rugby Union 16 Chapter 3: Intrinsic risk factors associated with illnesses during the 2010 Super Rugby tournament a prospective cohort study involving 22676 player days 43 Chapter 4: Summary and conclusions 69
HUBUNGAN LAMA KERJA, SIKAP KERJA DAN BEBAN KERJA DENGAN MUSKULOSKELETAL DISORDERS (MSDs) PADA PETANI PADI DI DESA AHUHU KECAMATAN MELUHU KABUPATEN KONAWE TAHUN 2017

Musculosceletal Disorders (MSDs) merupakan keluhan bagian otot skeletal yang dirasakan oleh seseorang mulai dari keluhan ringan sampai dengan keluhan berat, yang umumnya terjadi karena peregangan otot yang terlalu berat dan durasi pembebanan yang terlalu lama, sehingga dapat menyebabkan kerusakan pada sendi, ligament dan tendon. Pada awalnya, keluhan muskuloskeletal berupa rasa sakit, nyeri, mati rasa, kesemutan, bengkak, kekakuan, gemetar, gangguan tidur, dan rasa terbakar yang berakibat pada ketidakmampuan seseorang untuk melakukan pergerakan dan koordinasi gerakan anggota tubuh sehingga berdampak pada kurang efisiennya dan kehilangan waktu kerja serta menurunnya produktivitas kerja. Tujuan dalam penelitia ini adalah untuk mengetahui hubungan lama kerja sikap kerja dan beban kerja dengan muskuloskeletal disororders pada petani padi didesa Ahuhu kecamatan meluhu. Metode penelitian yang digunakan observasional analitik dengan desain studi cross sectional Populasi penelitian ini adalah para petani yang berjumlah 174. Sampel dari penelitian ini sebanyak 62 petani dari populasi sebesar 174 petani padi. Hasil penelitian menunjukkan bahwa ada hubungan secara stasistik (ρ < 0,008) variabel lama kerja (ρ = 0,005) dan sikap kerja (ρ < 0,018) serta beban kerja yaitu (ρ < 0,00) pada petani padi di desa ahuhu kecamatan meluhu kabupaten konawe. Saran bagi pekerja yaitu u ntuk menyesuaikan posisi membungkuk saat melakukan bercocok tanam sehingga posisi bekerja lebih nyaman sehingga dapat meminimalisir resiko terjadinya muskuloskel etal disorders (MSDS) dan memperbanyak jeda istirahat dalam sehari untuk mengurangi keluhan muskuloskeletal disorders dan dapat meringankan kerja otot , sedangkan bagi peneliti selanjutnya yaitu untuk penelitian selanjutnya diharapkan dapat meneliti variab el – variabel lain yang kemungkinan memiliki hubungan signifikan dengan muskuloskeletal disorders (MSDS) yang tidak diteliti pada peneliti ini dan lebih mengembangkan lagi. Kata kunci :Muskuloskeletal Diso rders,petani padi, lama kerja, sikap kerja, beban kerja
Amphetamine Paired With Physical Therapy Accelerates Motor Recovery After Stroke

Background and Purpose In animal models of brain injury, administration of numerous pharmaceuticals is reported to facilitate functional recovery. However, only drugs that increase the release of norepinephrine have been shown to promote recovery when administered late (days to weeks) after injury. To determine whether these findings were applicable to humans, we administered the norepinephrine stimulant dextroamphetamine, paired with physical therapy, to hemiplegic stroke patients. Methods Ten hemiplegic patients who suffered an acute ischemic infarction were entered between days 16 and 30 after onset and randomly assigned to receive either 10 mg of dextroamphetamine or a placebo orally every fourth day for 10 sessions paired with physical therapy. The Fugl-Meyer Motor Scale was used at baseline, within each session, and for 12 months after onset as the dependent measure. Confounding medications such as α-adrenergic antagonists or agonists were excluded in all subjects. Results Although there were no dif.
Living Caring in Practice: The Transformative Power of the Theory of Nursing as Caring

The purpose of this paper is to describe nursing as caring as a model for transforming practice. The purpose is achieved through presentation and analysis of nursing situations offered by a staff nurse in an Emergency Sewices Department and the nurse director of that department. The analysis of these situations of caring between nurse and nursed illuminates the power of theory-based practice focused on enhancing living grounded in caring.
Recurrent infestation with pediculosis capitis among aged 10-11 students in Hulu Langat, Selangor

ABSTRACT Background: Recurrent Pediculosis capitis may lead to various physical, economical and psychological consequences. The aim of the study was to determine the level of recurrent Pediculosis capitis, identify the factors associated with the recurrence and its predictors. Materials and Methods: The study used cross-sectional study design. Ten schools were included in the study. A total of 4,390 students from standard four and five were screened for Pediculosis capitis. Only 308 students diagnosed with Pediculosis capitis were included and treated. After 6-weeks, the recurrent infestation level was determined. Result: The total level of recurrent infestation was 8.30%. Contact with person with lice infestation was associated with recurrent Pediculosis capitis (χ2 = 3.557, df =1, P = 0.050). Hair type (χ2 = 4.388, df =1, P = 0.036) and hair length (χ2 = 4.225, df =1, P = 0.040) showed significant association with recurrent Pediculosis capitis. Those with previous contact with an infested person had odds of 3.263 to have recurrent infestation at 6-weeks as compared to those without previous infestation (AOR=3.262, 95% CI = 1.138 – 9.356, P=0.028). The respondents with curly hair had the odds of 2.89 times higher than those with straight hair to have recurrent infestation at 6-weeks (AOR = 2.895, 95% CI = 1.155 -7.257, P = 0.023). Conclusion: The total level of recurrent infestation was 8.30%. It is associated with contact with person with Pediculosis capitis, hair type and hair length. Recurrent Pediculosis capitis is still a public health problem and necessary intervention must be taken to prevent or reduce its occurrence. Keywords: Recurrent infestation, re-infestation, Pediculosis capitis, primary school, Hulu Langat.
Use of topical steroids on the face among university students in Saudi Arabia

Background: Topical corticosteroids are widely used to treat dermatological problems. The aim of this study is to assess the scale of topical steroid usage on the face among the university students. Methods: An online questionnaire has been sent by e-mail to all students of King Abdulaziz University (Jeddah, Saudi Arabia). It included questions about the use of topical steroids on the face for the last 5 y. Different photos of commonly used topical steroids including combination formulas were shown and asked if they have been used. Results: 1626 students responded. Only 56 responded as they have used topical steroids on the face in the previous 5 y. At least 189 had used one of the presented photos (which contained steroids) and 637 said that they did not know that they contained steroids. Sources of prescription included dermatologists, other doctors, pharmacists, friends and relatives, beauticians or saloon staff and others. Different recognized side effects were reported. Conclusion: Considerable number of university students use topical steroids on the face without knowing its nature. Additionally, Topical steroids are being prescribed and advised by non-medical personnel. Public awareness actions can be implemented to warn against the use of topical steroids without proper medical consultation.
Perceptions of caregivers regarding engagement with integrated management of chronic kidney disease patients in selected public hospitals of KwaZulu-Natal region, South Africa

Background Chronic kidney disease (CKD) patients rely on non-professional health care providers, namely caregivers to manage their long-term condition. Despite the growing literature on CKD patients, little is known about the perceptions of caregivers regarding integrated management of CKD. Aim The aim of the study was to explore the perceptions of caregivers with regard to integrated management of CKD patients. Setting The study took place in selected public hospitals of KwaZulu-Natal Province, South Africa. Method A qualitative case study design was used. A purposive sampling method was used to select the study participants. Data were collected through a semi-structured interview schedule developed from the literature. Data were analysed through thematic template approach using Health Belief Model constructs. Results Hypertension and diabetes mellitus were risk factors that worsen progression of CKD. Unemployment, lifestyle changes and limited social interaction were revealed as negative effects of CKD. Caregivers were aware of consequences of non-engagement with integrated management. The revealed positive benefits of integrated management were mainly physiological and system-related. Barriers to engagement with integrated management were side effects of diet and haemodialysis, hot weather, unemployment, false perception of good health and shortage of kidneys for transplant. Conclusion Chronic kidney disease patients require caregivers support to help with necessary changes to cope and adapt with integrated management of the disease. These caregivers experience effects of CKD, consequences of non-engagement and barriers to integrated management. Identification of caregivers perceptions offers healthcare workers a better understanding and formulation of strategies that can offer adequate support to this population.
Coupling Bacterioplankton Populations and Environment to Community Function in Coastal Temperate Waters

Bacterioplankton play a key role in marine waters facilitating processes important for carbon cycling. However, the influence of specific bacterial populations and environmental conditions on bacterioplankton community performance remains unclear. The aim of the present study was to identify drivers of bacterioplankton community functions, taking into account the variability in community composition and environmental conditions over seasons, in two contrasting coastal systems. A Least Absolute Shrinkage and Selection Operator (LASSO) analysis of the biological and chemical data obtained from surface waters over a full year indicated that specific bacterial populations were linked to measured functions. Namely, Synechococcus (Cyanobacteria) was strongly correlated with protease activity. Both function and community composition showed seasonal variation. However, the pattern of substrate utilization capacity could not be directly linked to the community dynamics. The overall importance of dissolved organic matter (DOM) parameters in the LASSO models indicate that bacterioplankton respond to the present substrate landscape, with a particular importance of nitrogenous DOM. The identification of common drivers of bacterioplankton community functions in two different systems indicates that the drivers may be of broader relevance in coastal temperate waters.
Blood Lipids and First-Ever Ischemic Stroke/Transient Ischemic Attack in the Bezafibrate Infarction Prevention (BIP) Registry

Background— Despite unclear associations between blood lipids, including fractionated cholesterol and triglycerides, and stroke, recent evidence demonstrates that lipid-modifying agents decrease the risk of stroke in patients with coronary heart disease (CHD). Methods and Results— Patients with documented CHD who were screened for but not included in the Bezafibrate Infarction Prevention study and had no history of stroke or transient ischemic attack (TIA) (n=11 177) were followed up. At baseline, medical histories were obtained and blood lipids assessed at a central study laboratory. During a 6- to 8-year follow-up period, 941 patients were identified as having nonhemorrhagic cerebrovascular disease, of whom 487 had verified ischemic stroke (per clinical findings and brain CT) or TIA. Patients experiencing an ischemic stroke/TIA had higher mean levels of triglycerides, lower levels of HDL cholesterol, and lower percentages of cholesterol contained in the HDL cholesterol moiety (%HDL; P<0.01 for all). In .
Music and refugees’ wellbeing in contexts of protracted displacement

Objectives: The aim of this study was to improve understanding of the relationship between music practice and the wellbeing of young refugees, by examining the perspectives of Yazidi music participants aged 11–18. Design: Focused exploratory case study design, informed by the Ottawa Charter for Health Promotion which provided the conceptual framework for the research. Setting: A camp in northern Greece, where people from Iraq and Syria had been living for up to a year. Method: Data were collected over a 5-week period through participant observation of individual music lessons and group music workshops involving between 3–12 participants. In addition, semi-structured interviews were conducted with a sub-sample of six participants (three boys and three girls) aged 11–18. Results: Findings indicate that activities involving music practice can impact positively on young people’s wellbeing, enabling the development of emotional expression, improved social relations, self-knowledge and positive self-identification, and a sense of agency. Conclusion: The positive impacts of music practice noted here suggest it has the potential to be a promising health promotion approach for young refugees, by helping to develop supportive environments, through which community action can be strengthened and personal skills developed.
Effects of moderate exercise training and detraining on diabetic peripheral neuropathy in streptozotocin-induced diabetic rats

Context Exercise training programs have been shown to have prophylactic effects on diabetes-associated complications in murine models. Objective The present study aimed to elucidate the effect of moderate exercise training for 4 weeks and detraining for 2 weeks on diabetic peripheral neuropathy in type 1 diabetic rat model. Materials and methods Type 1 diabetes was induced by a single intraperitoneal injection of streptzotocin (45 mg/kg). Exercise training lasted for 4 weeks in trained group, whereas the detrained group stopped training for 2 weeks after training for 4 weeks. After 4 weeks, tail flick test latency, body weight, serum glucose, inflammatory markers, and nerve growth factor levels were measured, and the same was done in detrained diabetic rats after 2 weeks of detraining. Results Moderate exercise training for 4 weeks increased significantly tail flick latency and nerve growth factor levels, whereas the inflammatory markers were significantly improved compared with diabetic sedentary rats. Interestingly, the prophylactic effects of exercise training were maintained in the detrained rats after 2 weeks of detraining. Conclusion Our results explore the prophylactic mechanisms underlying the exercise training in diabetic peripheral neuropathy rat model and give further insights into the maintained prophylactic effects that lasted after 2 weeks of detraining.
A Retrospective Comparison between the PNST and other Paediatric Nutritional Screening Tools

Background : Although it is widely acknowledged that hospitalized children are at greater risk of malnutrition, the available paediatric Nutritional Risk Screening (NRS) tools have not yet become universally used to identify those children at greater risk. Furthermore, the utility of one NRS tool over another remains unclear. Materials and Methods : The utility of a recently developed tool, the Paediatric Nutritional Screening Tool (PNST), was evaluated using data previously collected in the assessment of three other NRS tools in 281 children from Iran and New Zealand. The sensitivity and specificity of each tool was then assessed based on the WHO criteria for malnutrition. Results : The PNST recognized about half of the malnourished patients while the other three tools identified at least 85% of these children. The sensitivity of PNST for moderate (BMI-z < 2) and severe malnutrition (BMI-z <-3) was 37% and 46% respectively, while the sensitivity for other three NRS tools ranged from 82-100%. Conclusion : In this data set, the PNST tool did not perform as well as the three more established NRS tools. Further work is required to provide optimal tools for the identification of hospitalized children at risk of malnutrition.