Miracle-dz/UniFAR-FTUs huggingface dataset:
The impact of educational interventions on influenza and pneumococcal vaccination rates in primary care

Background. Influenza and pneumococcal vaccinations are important therapies supported by national and international guidelines for preventing morbidity and mortality from respiratory illnesses in high-risk groups. The responsibility for delivering these vaccinations in the United Kingdom lies with primary care. Little is known about how rates of influenza and pneumococcal vaccination can be increased in high-risk groups in primary care. Aim. To research methods of improving rates of influenza and pneumococcal vaccination in high-risk groups in primary care. Objectives. To investigate the impact of educational interventions for primary care teams on influenza and pneumococcal vaccination rates in high-risk groups. Method. The research had the following components: a. Literature search examining current practice and policy in relation to influenza and pneumococcal vaccination and studies undertaken to improve performance, both in general and specifically in relation to improving adult vaccination rates. b. Pilot study of targeting influenza and pneumococcal vaccination to high-risk groups in a single general practice. c. Effect of audit and feedback with an information pack to primary care teams on influenza and pneumococcal vaccination in primary care: before-and-after multipractice study. d. Effect of audit and feedback with an information pack to primary care teams, as part of a clinical governance programme, on influenza and pneumococcal vaccination in a primary care trust: before-and-after multipractice study. e. Randomised controlled study of an educational outreach intervention partly nested within primary care trust study with audit, feedback and information (passive dissemination of guidelines and recommendations) directed at primary health care teams compared with audit feedback and information alone using multifaceted interventions to increase influenza and pneumococcal vaccine uptake in high-risk groups in primary care. Results. The studies demonstrated significant improvements in influenza and pneumococcal vaccination rate in high-risk groups in primary care, showed the levels of improvement that could be expected from these types of intervention and described how primary care teams responded to direct and indirect educational interventions supported by measurement of performance. Conclusions. Education to multiprofessional teams is an important method for diffusion of innovations in the highly professionalised organisations of primary care and general practice. Educators need to understand the complex nature of primary care organisations and teams, when and how education for teams is likely to be successful, the barriers to implementation of new ideas and how to address these. Education when applied appropriately can have important effects in improving health care. This is more likely to occur when careful assessments are made around the nature of the evidence, clear outcomes are sought and measured and the healthcare intervention is understood from the perspective of the patient, the healthcare team and other stakeholders.
(E)-1-(2-Aminophenyl)-3-(3,4,5-trimethoxyphenyl)prop-2-en-1-one

In the asymmetric unit of the title chalcone derivative, C18H19NO4, there are three crystallographically independent molecules (molecules A, B and C). In molecule A, the dihedral angle between two benzene rings is 12.22 (10)° and the plane of the central prop-2-en-1-one unit makes dihedral angles of 11.02 (13) and 2.64 (12)° with the two adjacent benzene rings. The corresponding angles in molecule B are 12.35 (10), 18.78 (12) and 7.29 (12)°, respectively, and those in molecule C are 15.40 (10), 15.62 (3) and 3.19 (13)°. In each molecule, an intramolecular N—H⋯O hydrogen bond generates an S(6) ring motif. In the crystal structure, the molecules B are linked by intermolecular N—H⋯O hydrogen bonds into a zigzag chain along the c axis, while the molecules A and C are linked together via an N—H⋯O hydrogen bond into a dimer. Adjacent dimers are further connected by N—H⋯N hydrogen bonds into a three-dimensional network. Weak C—H⋯O and C—H⋯π interactions are also observed.
Risky sexual behaviour of university students : perceptions and the effect of a sex education tool

The increasing HIV incidence amongst people aged 15-24 years and the reported gaps in sexeducation received at school and reported risky sexual behaviour in South Africa justifies the importance of this study. This study examines the risky sexual behaviour and perceptions among first-year students enrolled at Monash South Africa in South Africa. This four-phased mixed methods pilot study explored whether a sex-education intervention tool positively influenced risky sexual behaviour. Phase 1 used self-administered questionnaires to obtain quantitative and qualitative baseline data. In Phase 2 a sex-education intervention tool was designed to address identified gaps. In Phase 3 a prospective cohort of 12 mixed-gender students participated in the sex-education intervention sessions and was followed up a month later (Phase 4) to evaluate the effectiveness of the tool. Phase 1 participants (139) were between 18- 21 years. The level of sexeducation knowledge amongst the participants was low and of a poor quality; this could be a result of poor preparation at school. The results suggest the necessity of sex-education programmes for university students considering the low proportion of students entering university with basic sex education. Of the 139 participants, 27 were identified with risky sexual behaviour and considered for an intervention. The intervention participants felt more able to be responsible for their behaviour after the intervention. The participants reported that the sexeducation intervention tool influenced their risky sexual behaviour positively. This pilot intervention study can be adopted by universities interested in engaging their students about their sexual health and augmenting school-level interventions. Keywords : University students, sex-education, intervention, sexual health, risky sexual behaviour.
Antibiotic Resistance Pattern and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Colonization in Burns Unit of a Tertiary Care Hospital in Peshawar, Pakistan

Purpose : To develop strategies for the control of hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) which is a serious threat to burns patients with the aid of molecular studies. Methods : Staphylococcus aureus strains were collected from the Burns Unit of Khyber Teaching Hospital (KTH) Peshawar, Pakistan from July - December 2011. Antibiotic resistance was determined according to the recommendations of Clinical Laboratory Standard Institute (CLSI). Molecular epidemiology of the S. aureus strains were determined by pulse field gel electrophoresis (PFGE). Results : PFGE identified 14 clusters which included 29 different pulso-types prevailing in the Burns Unit. Of the 29 types, 11 contained two or more strains of the same pulso-type. These MRSA isolates were highly resistant to various kinds of penicillin and cephalosporin (85 – 100 %). Among the important anti-staphylococal agents tested, 17 % of the isolates were resistant to fusidic acid and linezolid. All the 54 strains were susceptible to vancomycin. Conclusion : Several of the same pulso-types prevail in the Burns Unit of KTH. Furthermore, 29 pulsotypes mong the 54 strains suggest the diversity of the MRSA strains collected from burns patients. Keywords : Epidemiology, Pulso-type, Fusidic acid, Linezolid, Vancomycin, Methicillin-resistant Staphylococcus aureus, Burns
2-Cyano-N′-[1-(pyridin-2-yl)ethylidene]acetohydrazide

In the title compound, C10H10N4O, the dihedral angle between the pyridine ring and the –C=O(CH2)CN group is 24.08 (12)°. In the crystal, inversion dimers linked by pairs of N—H⋯N hydrogen bonds generate R 2 2(8) loops.
MILDRONATE: AN ANTIISCHEMIC DRUG WITH MULTIPLE INDICATIONS

Summary Mildronate (3-(2,2,2-trimethylhydrazine)propionate; THP; MET-88; meldonium, quaterine) is an anti-ischemic drug developed in the Latvian Institute of Organic Synthesis. Mildronate was designed as a promising inhibitor of carnitine biosynthesis aimed to prevent accumulation of cytotoxic intermediate products of fatty acid beta- oxidation in ischemic tissues and to block this highly oxygenconsuming process. Actually Mildronate is used in several countries in cardiology (treatment of chronic heart ischemic disease, stable angina pectoris, chronic heart failure, functional disorders of heart and vessels, cardiomyopathy, heart infarction), neurology (acute and chronic ischemic brain circulation disorders, decreased work capabilities, physical and emotional overload, recovery period after various diseases), pulmonology (bronchial asthma and obstructive bronchitis), narcology (abstinence syndrome in chronic alcoholism), ophthalmology (hemophthalm and retina haemorrhages of different aetiology, thrombosis of central vein and its branches in retina, diabetic and hypertonic retinopathies). The main mechanism of action of Mildronate is based on carnitine biosynthesis inhibition aimed to prevent accumulation of cytotoxic intermediate products of fatty acid beta- oxidation in ischemic tissues and to block this highly oxygen-consuming process. Alternatively the drug acts via stimulation of the nitric oxide production in the vascular endothelium through a modification of the γ-butyrobetaine and γ-butyrobetaine ester pools. The present review will summarize data on the Mildronate on different indications of the drug and its mechanisms of action.
Proportion of hearing loss in chronic renal failure: Our experience

Introduction: This study is taken up to study the magnitude of sensorineural hearing loss (SNHL) in chronic kidney disease (CKD) patients. Two hundred patients (400 ears) who had CKD 5 and all patients underwent hemodialysis were taken into study. Methods: All patients had clinical ENT examination and audiological evaluation with pure tone audiometry and impedance audiometry. All patients had SNHL. Results: In summary, high frequencies are affected in 52%, middle frequencies in 9%, and low frequencies in 2.5% of individuals. About 2.5% of patients had hearing loss in all frequencies. Hearing loss is observed only at 8000 Hz in 10% of individuals. Among all patients, 21 patients (42 ears) underwent a renal transplant, and post-transplant duration was about 1 year, 11 patients (57%) having hearing loss. Thus, hearing loss was found in 122 (61%) members bilaterally. Unilateral hearing loss is present in 5 (2.5%) patients. Conclusion: Hearing loss is present in 63.5% individuals (249 out of 400 ears). Thus, SNHL is present in 63.5% in patients with chronic renal failure and severity correlated with duration of disease. No correlation between other covariables.
Sense of coherence, socioeconomic conditions, and health : Interrelationships in a nation-wide Swedish sample

This study explores the distribution of sense of coherence (SOC) in common demographic and socioeconomic subgroups in a nation-wide representative sample. It also explores the relationship between SOC and these conditions, on the one hand and self-reported indicators of health, on the other. The sample consisted of 2,003 Swedes; 976 men and 1,027 women. The mean age was 44.2 years (SD = 16.6 years). The sample was selected by SIFO, the biggest Swedish market research institute, to be representative of the Swedish population between the ages of 15 and 75 years. All participants responded to a mailed questionnaire including Antonovsky's short SOC questionnaire, common socioeconomic and sodal situation variables and health questions. The distribution of SOC scores in different subgroups was partly inconsistent with previous studies. A sex difference was found; men scored significantly higher on the SOC scale than women. Regarding age, SOC scores increased with increasing age. Bivariate statistics showed that SOC was more strongly related to general well-being and psychological symptoms than to overall physical health and somatic symptoms. SOC was also more strongly related to health among women than men. Multivariate statistics (separately for men and women) indicated that SOC was more strongly related to the health indicators than age, education and income levels, number of persons in the household and number of friends. The possibility of a conceptual overlap between SOC and self-assessments of health, well-being and psychological symptoms in particular is discussed.
Accuracy and Cost Comparison of Ultrasound Versus Alternative Imaging Modalities, Including CT, MR, PET, and Angiography

Ultrasound (US) has become widely used in clinical medicine for the diagnosis of a variety of disease processes. The unique ability of US to provide accurate information through an efficacious, painless, portable, and nonionizing method has expanded its role and application in diverse medical settings. Given the current economic environment and the related interest in creating the greatest value for health care expenditures, US has been evaluated to compare its clinical accuracy/efficacy and cost-effectiveness versus other imaging modalities. The following literature review reports the results of research studies aimed at comparing the accuracy/efficacy and cost of US versus alternative imaging modalities, including magnetic resonance imaging, computed tomography, contrast angiography, and single-photon emission computed tomography.
THE EFFECT OF PRIOR CYCLING ON LEG STIFFNESS DURING RUNNING IN HIGH PERFORMANCE TRIATHLETES

The purpose of this study was to investigate the influence cycling has on lower limb stiffness during the run leg in triathletes. Seven well trained triathletes completed a triathlon-run (TR; run preceded by a 40 km cycle) and a control-run (CR; run at the same pace as TR, but without a prior cycle). Vertical, hip, knee and ankle stiffness measured during double leg jumping (2.2 Hz) were compared both before and after the cycle leg and between TR and CR conditions. Maximum hip and knee moments and knee joint stiffness were significantly greater immediately following cycling. However, maximum hip moments and hip joint stiffness were lower in CR than TR. This study provided an insight into how joint stiffness is altered following cycling and may help explain the perceived loss of coordination reported frequently by triathletes at the start of the run leg.
Leprosy in Sukkur region: A series of 143 cases from 2001-2011 at leprosy centre Sukkur, Sindh

Objective To document the clinical characteristics of newly diagnosed leprosy patients in Sukkur Region, Sindh. Methods A total of 143 new leprosy cases referred and registered in leprosy centre, Sukkur from 2001-2011 were studied. Diagnosis was based on clinical grounds, and supported by acid-fast bacilli on slit-skin smear. Results Out of 143 new cases 73 (51%) were males and 70 (49%) females. The peak age of disease onset was second decade. The most common form of the disease was borderline tuberculoid (BT) seen in 76 (53%) cases. Ulnar nerve was the most frequently affected nerve seen in 30 (21%) cases. Conclusion Although in urban cities the cases of leprosy are in decline but still it exists in rural areas of Sindh. It is important for the practitioners to be aware of its diagnosis and management to prevent the deformities
Rural disadvantage in breast cancer health-care service use and outcomes: quantifying the effects of individual risk factors and health service risk factors

3 Publications during candidature . 6 Publications included in this thesis . 10 Acknowledgements . 16 List of figures and tables . 20 Glossary . 24 List of abbreviations. 26 Introduction . 27 Chapter 1. Literature review . 29 Chapter 2. Research methodology . 47 Chapter 3. Study 1 – Rural disadvantage in mammography service use . 56 Chapter 4. Study 2 – Breast screening patterns in urban and rural Australia . 82 Chapter 5. Study 3 – Rurality and a late stage of breast cancer diagnosis . 111 Chapter 6. Study 4 – Advanced breast cancer in rural and urban Australia . 136 Chapter 7. Study 5 – Breast cancer, social support and quality of life . 154 Chapter 8. Thesis discussion. 173 Chapter 9. References . 186
The presence of bla1, bla-SHV and bla-TEM in ampicillin-resistant bacteria from agricultural soil samples

Abstract. Antibiotic resistance in the environment occurs naturally in bacteria, and is a growing problem due to the use of antibiotics both in human and animal medicine. β-lactamases are the most studied group of antibiotic resistant genes, as these enzymes hydrolyze penicillin, ampicillin, and other β-lactam antibiotics. The purpose of this study was to determine if there was a statistically significant difference between numbers of copies of β-lactamase genes (bla1, bla-TEM, bla-SHV) from ampicillin-resistant bacteria in soil samples from a horse pasture and a crop field. Colony counts suggested there was a significant difference (p < 0.05) in ampicillin-resistant bacteria between the two soil samples. Upon completion of PCR and gel electrophoresis, there was no statistically significant difference in the presence of bla1 and bla-TEM (p > 0.05) in bacteria from each soil sample, but there was a significant difference in the presence of bla-SHV (p = 0.0061). A significant difference in ampicillin-resistant colonies and bacteria with bla-SHV suggests that ampicillin used in the horses may be selecting for ampicillin resistance in the soil bacteria. There may also be high concentrations of other ampicillin-resistant genes present in agricultural rich soils, particularly in animal pastures. Future studies need to be undertaken to document the level of antibiotic resistance found in animal pastures to understand the impact this may have on animal and human health.
Genealogical Position of Japanese Populations of the Globally Distributed Mayfly Cloeon dipterum and Related Species (Ephemeroptera, Baetidae): A Molecular Phylogeographic Analysis

In the present study, we add genetic data of the mayfly Cloeon dipterum collected from the Japanese Islands to the established molecular phylogenetic knowledge in the mitochondrial COI gene of Cloeon mayflies. Cloeon dipterum is a typical cosmopolitan species that includes six intraspecific haplotype groups. The present phylogenetic analysis revealed that haplotypes of the Japanese C. dipterum constitute a seventh group together with a haplotype from Korea. This East Asian group forms a sister group with previously known European and North American haplotype groups (i.e., the clade CT1 to CT3). The present phylogenetic analysis further revealed the occurrence of two described species (C. dipterum and Cloeon ryogokuensis) and possibly three species (Cloeon sp. 1 to 3) in Japan. Consideration is given to the degree of genetic differentiation, divergence time, and differentiation process among these seven genetic groups.
Do Reproductive Modes and Swimming Ability Influence Occurrence of Non-Marine Ostracod (Crustacea) Species among Aquatic Habitats?

To gain a better understanding of the effect of reproductive modes and swimming ability on ostracod distribution, we visited 111 randomly selected aquatic sites in Kırşehir province. A total of 35 ostracods were newly reported for the area. The number of species with and without swimming setae was not statistically different, but numbers of sexual species was significantly lower than parthenogenetics. Species without setae did not show a significant difference between sexual and parthenogenetic forms. Numbers of species with (out) setae were not significant among different elevational ranges. Distribution of parthenogenetic species was common in all 11 habitat types when sexual species were only found from three different types located from 690 to ca. 1400 m of elevational ranges. Numbers of parthenogenetic species with or without setae did not show a difference among the ranges, but sexual species without setae exhibited wider distributional ranges (690–1289 m) than species with swimming setae (690–1089 m). Species' co-occurrence revealed two positive, five negative, and 44 random pairs of co-occurrences. Wards cluster analyses portrayed three main clustering groups. While group I includes parthenogenetic and sexual species, group II covers mostly parthenogenetic species with and without setae. Group III consists of species without setae. CCA results displayed three environmental variables (water temperature, pH and elevation) effective on species distribution. Species distributed in all elevational ranges tend to show lower optimum and wider ecological tolerances. Parthenogenetic species with swimming setae and with relatively higher tolerance ranges were dominant over sexual species. The present results suggest that swimming mode has a greater effect on species distribution among the habitats than reproductive modes.
Plant minus air temperature corresponds to different responses to water stress in wheat, canola, and chickpea grown in the semiarid Canadian prairie

Abstract: The difference between plant and air temperature (PT–AT) is a good indicator of water stress. PT–AT for chickpea was negatively correlated to water deficit and air temperature and positively correlated to wind; for wheat, PT–AT was positively correlated to water deficit, air temperature and solar energy; for canola, PT–AT was not correlated to the environment. Chickpea maintained positive turgor at the expense of water content and therefore more water was available for transpirational cooling. Wheat maintained water content at the expense of turgor and therefore there was little water available for transpirational cooling. For canola, PT–AT was affected by parameters other than environment.
Persistent postarthroplasty knee pain

Knee arthroplasty is done to relieve pain. The procedure itself can cause long lasting pain which can significantly decrease the quality of life and mobility. The factors leading to pe rsistent pain relate to patient and surgery and the management of pain before and after the surgery. The management of persistent arthroplasty pain is multidisciplinary and involves conservative and interventional pain medicine.
Early Signs of Microvascular Complications in Pediatric Patients with Short Duration of Type 1 Diabetes Mellitus Seen in Southeast Nigeria

Background: Clinically evident microvascular complications are rarely seen among children and adolescents with type 1 diabetes mellitus (T1DM), although early signs develop during childhood and accelerate during puberty. Aim: The aim of this study was to determine the prevalence of early signs of microvascular complications in children and adolescents aged 9–19 years with a short duration of T1DM by screening for retinopathy and nephropathy. Methods: A cross-sectional study and participants were consecutively enrolled from the Endocrinology Clinic at Federal Teaching Hospital, Abakaliki. Physical examination and mydriatic ophthalmoscopy were conducted. Three early morning spot urine specimens for albumin/creatinine ratio were estimated 3 months apart. Serum creatinine levels were estimated, and the glomerular filtration rate was calculated. Glycosylated hemoglobin (HbA1c) was determined. Results: Twenty-four individuals participated, 15 (62.5%) were male and the mean age at diagnosis was 12.4 ± 2.3 years. The mean duration of diabetes was 23.8 ± 20.6 months. The mean HbA1c was 11.4%. Retinopathy was seen in 16.7%, whereas 33.3% had microalbuminuria. Blood pressure range was within the 50th–90th percentile for all the participants. Conclusion: The study outcome demonstrated a high prevalence of early signs of microvascular complications such as retinopathy and nephropathy among youths with short duration of T1DM. Poor glycemic control, if not halted, is associated with early signs of microvascular complications which may become clinically evident; contrary to the belief that they are rare in childhood.