Miracle-dz/UniFAR-FTUs huggingface dataset:
Diagnostic accuracy of a new clinical test (resisted internal rotation) for detection of gluteus medius tears

Abstract The objective of this study was to evaluate the diagnostic accuracy of a new dynamic clinical examination for detection of gluteus medius (GM) tears. A case group of 50 patients undergoing arthroscopy with GM repair was compared with a control group of 50 patients undergoing arthroscopy who had no peritrochanteric symptoms. Both groups were examined clinically, had magnetic resonance imaging studies performed and underwent arthroscopic surgery. Recorded clinical examinations included abnormal gait (Trendelenburg), tenderness to palpation of the greater trochanter, resisted abduction and the test being studied, resisted internal rotation. For all clinical tests, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rates were calculated and compared with the arthroscopic and MRI data for the case group, and the MRI data for the control group. The resisted internal rotation test had a sensitivity of 92%, specificity of 85% and diagnostic accuracy of 88% in the detection of GM tears, with a low rate of false-positive and false-negative recordings. Other traditional clinical examination tests, with the exception of Trendelenburg gait, showed inferior rates. Trendelenburg gait had a higher specificity, but much lower sensitivity. The resisted internal rotation test aides in the detection of GM pathology. Due to the good results of the resisted internal rotation test in all the diagnostic parameters, we recommend incorporating it on the physical exam of patients with hip pain.
Efficiency and safety of intrathecal morphine for analgesia after hysterectomy

Introduction/Objective. This prospective, randomized study was done to determine the efficiency and safety of the administration of intrathecal morphine chloride combined with the local anesthetic levobupivacaine given to female patients subjected to hysterectomy to ensure postoperative analgesia. Methods. The study sample consisted of 50 patients who were to undergo hysterectomy with adnexectomy and they were divided into two groups of 25 each. The patients in group A were given the combination of 0.3 mg of morphine chloride with 1.7 ml of 0.5% levobupivacaine immediately before the surgery, whereas the patients in group B were intravenously administered 5 mg of morphine chloride before the end of surgery, and after the surgery at certain time intervals. The postoperative pain was assessed at the first, sixth, 12th, and 24th hour by Numeric Rating Scale (NRS). Side effects, such as nausea, vomiting, itching and respiratory depressions were followed as well. Results. The postoperative pain was less expressed at any time interval both at rest and on exertion in group A (p < 0.001) and therefore the need for additional analgesia was less in group A (p < 0.001). The subjective feeling of satisfaction with postoperative analgesia was statistically significant in group A (p < 0.001). Conclusion. Intrathecal administration of morphine chloride combined with levobupivacaine ensures better postoperative analgesia after hysterectomy than intravenous morphine chloride, their side effects being equally frequent.
A comparative study between Australian and South African university sport students' volunteer motives and constraints : sport management and governance

Volunteering plays an integral part in the success of numerous South African and Australian organisations and university students have been identified as a latent target population with the greatest potential for volunteering. Organisations who wish to recruit students should be knowledgeable regarding their motives and constraints in order to increase community and sport volunteer activities. The purpose of this study was to identify and compare the motives and constraints influencing volunteerism amongst South African and Australian sport students. A non-probability convenience sampling design was used to collect data from 278 South African and 208 Australian students enrolled in a sport curriculum at two universities in the Gauteng province and three universities within the Queensland area. The volunteer questionnaire developed by Auld and Cuskelly (2001) was used to gather data. The study identified slight egoistic differences in volunteer constraining and motivating factors between South African and Australian sport students. However, students from both countries indicated a low social motivation factor but an equal perceived confidence in their ability to solve problems when volunteering. The comparative results could aid organisations to broaden their current recruitment operations.
Screening for Chlamydia Trachomatis and Neisseria Gonorrhoeae During Pregnancy: A Health Technology Assessment

The purpose of this health technology assessment (HTA) is to conduct a systematic assessment of the clinical effectiveness, safety, cost-effectiveness, and perspectives and experiences of pregnant persons, partners, and health care providers regarding the screening of pregnant persons for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) during pregnancy.
Deep Phenotyping of Development, Communication and Behaviour in Phelan-McDermid Syndrome

Phelan-McDermid syndrome (PMS; also referred to as 22q13.3 deletion syndrome) is a congenital condition due to a microdeletion in the SHANK3 gene. Cognitive and communicative deficits as well as behaviour in the autism spectrum are often noticed in affected individuals. The aim of the present study was to obtain a detailed phenotype of the development, communication, and behaviour of 15 individuals with PMS by using both quantitative (questionnaires) and qualitative methods (interviews and observations). In addition, data from the patients' medical records were included. In a subgroup of participants (n = 5), data from a previous study were incorporated to enable a comparison over 2 points in time (longitudinal course). Results indicate a severe to profound level of intellectual disability in all participants, impaired adaptive behaviour, a low level of speech and language, a high incidence of features of autism spectrum disorder (ASD), and a high sensory threshold. Younger individuals (age <18 years) exhibited more challenging behaviour and features of ASD. In older individuals with PMS, a regression across many developmental and adaptive domains was frequently reported and observed. We did not find a relation between the deletion size and the severity of the phenotype. Implications of the findings and recommendations for clinical practice and future research are discussed.
The Effect of Aerobic Training with Vitamin C Supplementation on Myeloperoxidase, Asymmetric Dimethyl Arginine and Blood Pressure in Middle-Age Hypertensive Overweight Men

Background: Cardiovascular diseases such as hypertension are global health concerns. Objectives: The purpose of this study was the eﬀect of intensive aerobic training with vitamin C supplementation on myeloperoxidase (MPO), asymmetric dimethyl arginine (ADMA), and blood pressure (BP) in hypertensive men. Methods: Fortyhypertensivemen(age: 44.6 ± 3.5y,bodymassindex: 28.2 ± 1.2kg.m -2 )volunteeredtoparticipateinthisstudyand wererandomlydividedintofourgroupsof aerobictrainingwithvitaminC(ATV;N=10),aerobictrainingwithplacebo(ATP;N=10), vitamin C group (VC; N = 10) and control (Con; N = 10). The exercise training consisted of running training, which was done three timesaweekfor10weeks,withtheintensityof 75% -85% HRmax,andthedurationof 20-45minutes. ATPandVCgroupsconsumed daily500mgof vitaminCorplacebo. Fastingbloodsamplesweremeasuredbeforethestarttrainingprotocoland24hourafterlast training sessions to measure MPO and ADMA in the serum. Results: TheresultsofpresentstudyshowedthatADMAandBPweresigniﬁcantlydecreasedonlyinATVandATP(P ≤ 0.05). However, MPO did not change signiﬁcantly (P > 0.05). Also, were seen that no signiﬁcant diﬀerence between ATV and ATP groups (P > 0.05). Conclusions: It can be concluded that, aerobic training caused to decrease of dimethyl arginine, that can be a good strategy for control or decrease of blood pressure in hypertensive subjects, however intensive aerobic training with vitamin C may have better eﬃcacy.
Prevalence and Correlates of Caffeine Use Disorder Symptoms Among a United States Sample

Background: The DSM-5 recognizes caffeine use disorder as a condition for further study, but there is a need to better understand its prevalence and clinical significance among the general population. Methods: A survey was conducted among an online sample of 1006 caffeine-consuming adults using demographic quotas to reflect the U.S. population. Caffeine consumption, DSM-proposed criteria for caffeine use disorder, sleep, substance use, and psychological distress were assessed. Results: Eight percent of the sample fulfilled DSM-proposed criteria for caffeine use disorder. These individuals consumed more caffeine, were younger, and were more likely to be cigarette smokers. Fulfilling caffeine use disorder criteria was associated with caffeine-related functional impairment, poorer sleep, some substance use, as well as greater depression, anxiety, and stress. Conclusions: The prevalence of caffeine use disorder among the present sample suggests that the proposed diagnostic criteria would identify only a modest percentage of the general population, and that identified individuals experience significant caffeine-related distress.
Description of Parents’ Knowledge, Gluten Free Casein Free (GFCF) Intake Frequency and Autism Children Behavior in Palembang

Autism is a representation, a general characterized by "a bunch of failure" to describe and categorize individuals behavior describing failures in social relationships, communication, and imagination ability. To develop ability on children with autism to be close to normal, diagnosis methods through early, integrated and intensive treatment were used. One type of therapy for children with autism is through food or the so-called Gluten Free Casein Free (GFCF) diet therapy. The type of this research was descriptive with cross sectional design. The population in the study were all students with autism who were still active following treatment with a sample of 36 people who were taken by using purposive sampling. Results showed that mostly there are 80.6% parents who have knowledge, 55.6% samples never eat foods containing gluten, 50% samples never eat foods containing casein, 77.8% samples have a good energy intake, 100% samples have good protein intake, and 80.6% samples have mild autistic behavior. From the results of the study, it is expected that the parents can increase knowledge about the GFCF diet in order to improve their diet and reduce behavior disorders in autism children
Interpretation of bone densitometry and definition of osteoporosis in children and adolescents

Paediatric age is a crucial time for bone mass accrual. Every deterioration of bone status in this period of life can affect the condition of the skeleton in the future. The awareness of primary and secondary disorders affecting bone health is vital for the identification of children at risk of developing osteoporosis. Among currently available methods of measuring bone mineral density in children, dual energy X-ray absorptiometry (DXA) remains the method of choice. However, the interpretation of a paediatric DXA report is complicated, which can lead to a misdiagnosis. Unlike in adults, the result is given in the Z -score; the T -score should not be taken into account. The preferred sites of measurement are the total body less head, and the lumbar spine. The current recommendations for bone mineral density assessment are provided by the International Society for Densitometry.
Characterization of Infections Associated with Health Care in Pediatrics Bogotá 2017

Maria C Mejía1*, Luis G Piñeros2, Anibal A Teherán3 and Luis M Pombo4 1Physician, Epidemiologist, COMPLEXUS Research Group. Corpas University, Colombia 2Physician, Family Medicine Specialist, GIFVTA Research Group. Research Group. Corpas University, Colombia 3Physician, Epidemiologist, COMPLEXUS Research Group. Corpas University, Colombia 4CI GIFVTA Research Group. Corpas University, Colombia Submission: August 11, 2018; Published: October 15, 2018 *Corresponding author: Maria C Mejía, Physician, Epidemiologist, COMPLEXUS Research Group. Corpas University, Bogotá, Colombia, Tel: +5716622222; Email:
Pregnancy outcome in elderly primigravida

Background: Incidence of elderly primigravida has increased now days, due to rising education level, effective means of birth control and high carrier goals. The women who conceived in advanced age more than 35 years for first time is defined as elderly primigravida. Indian standard is fixed at more than 30 years by Dutta 2013. These women are high risk for maternal and foetal complication and outcome. The study was done to assess pregnancy outcome in elderly primigravida.Methods: This is a prospective hospital-based study done from October 2016 to November 2018. Women of reproductive age group with first pregnancy admitted to department of obstetrics and gynaecology, Veer Surendra Sai Institute of Medical Science and Research, Burla were taken after exclusion criteria.Results: The incidence of elderly primigravida was 2.51%. But majority (84.76%) though married early, conceived late. Most of them are belongs to high socioeconomic group (62.86%). Anaemia was commonest complication (28.57%), fibroid in 5.71% cases. Pre-eclampsia (18.09%), eclampsia (3.81%), IUGR (12.38%) and twin pregnancies (5.72%) were seen more frequently than young primigravida. 55.24% were developed complications during labour like foetal distress (33.33%), PPH (3.81%) and retained placenta (2.86%). Gestational diabetes mellitus in (0.95%), caesarean section rate 29.52%, normal delivery 51.42%, and congenital anomaly 8.15%. Conclusions: Elderly primigravida are high-risk for several complications like spontaneous abortion, preterm labour, prolonged labour, foetal distress, high caesarean rate, PPH, congenital anomaly and increased incidence of perinatal mortality. Majority of this patients properly supervised are capable of safe and successful pregnancies ending in healthy mother and healthy baby.
États de mal épileptique convulsifs ventilés à la phase initiale : étude rétrospective multicentrique du taux d’états de mal réfractaires et des modalités de gestion de l’anesthésie générale à la phase précoce en réanimation

L’etat de mal epileptique (EME) convulsif requiert souvent une ventilation mecanique (VM) : pour anesthesie generale (AG) en cas d’EME refractaire (duree recommandee de 24-48h) ou pour protection respiratoire. L’objectif est d’evaluer le taux d’EME convulsifs generalises refractaires (EME-G-R) parmi les patients admis en reanimation sous VM pour EME convulsif, de decrire la gestion de l’AG a la phase precoce et le pronostic de ces patients. Cette etude retrospective multicentrique, realisee dans quatre unites de reanimation entre 2014 et 2016, a pour criteres d’inclusion : admission en reanimation pour EME convulsif et intubation avant l’entree. Les EME post-anoxiques et les traumatismes crâniens aigus ont ete exclus. Les caracteristiques de l’EME, les traitements antiepileptiques (AE), la cause d’intubation, la duree de l’AG, la recidive d’EME et les complications ont ete recueillis. Sur les 248 dossiers eligibles, 100 ont ete inclus. Parmi les 87 EME convulsifs generalises, 16% sont refractaires. La raison principale d’intubation est le coma (58%) et un tiers des patients sont mis directement sous AG sans 2eme ligne d’AE en cas de persistance des convulsions apres la 1ere ligne d’AE. La duree mediane d’AG avant sevrage est de 12.25h [5-18.0], sans difference entre EME-G-R et non refractaire (respectivement 12.75h et 12h, p=0.8). Le taux de recidive d’EME est de 7%, et de deces de 3%. Une duree d’AG =12h avant sevrage est associee a un taux de complications moindre, sans majorer les recidives.La morbi-mortalite liee aux EME pourrait etre diminuee si la securite d’une AG =12h est confirmee par des donnees prospectives dans l’EME refractaire.
FACTORS OF SUBJECTIVE WORK FATIGUE ON SERVICE WORKERS DOCKING PT PAL INDONESIA (PERSERO)

Fatigue was a feeling of tiredness and a decrease in alertness to workers caused by psychological and physical factors . Fatigue will reduce performance and increase the level of work errors. The purpose of this study was to analyze the internal factors and external factors of subjective work fatigue on service workers docking maintenance division in PT PAL Indonesia (Persero). This study was an observational study with cross sectional design. The subject in this study was the total population (18 workers). The independent variables in this study were internal factors (age, working period, and nutritional status) and workload. Dependent variables were subjective work fatigue that measured by the International Fatigue Research Committee (IFRC) 30-item questionnaire general fatigue symptoms. The results of this study showed that the most fatigue felt by workers was moderate fatigue (50%). Moderate fatigue were experienced by workers ranging in age from 25 to 32 years (57.1%) with a working period of 24-32 years (54.5%), excessive nutritional status (50%), and light workload (54.5%). The conclusion of this study were that the more age increases, the longer the working period, the more nutritional status increases the fatigue of work experienced. The lighter the workload, the more work fatigue increases, it is caused by factors outside of work . Keywords : Subjective Work Fatigue, Internal Factor, External Factor
Circulating Cancer Stem Cell-Derived Extracellular Vesicles as a Novel Biomarker for Clinical Outcome Evaluation

The recent introduction of the “precision medicine” concept in oncology pushed cancer research to focus on dynamic measurable biomarkers able to predict responses to novel anticancer therapies in order to improve clinical outcomes. Recently, the involvement of extracellular vesicles (EVs) in cancer pathophysiology has been described, and given their release from all cell types under specific stimuli, EVs have also been proposed as potential biomarkers in cancer. Among the techniques used to study EVs, flow cytometry has a high clinical potential. Here, we have applied a recently developed and simplified flow cytometry method for circulating EV enumeration, subtyping, and isolation from a large cohort of metastatic and locally advanced nonhaematological cancer patients (N = 106); samples from gender- and age-matched healthy volunteers were also analysed. A large spectrum of cancer-related markers was used to analyse differences in terms of peripheral blood circulating EV phenotypes between patients and healthy volunteers, as well as their correlation to clinical outcomes. Finally, EVs from patients and controls were isolated by fluorescence-activated cell sorting, and their protein cargoes were analysed by proteomics. Results demonstrated that EV counts were significantly higher in cancer patients than in healthy volunteers, as previously reported. More interestingly, results also demonstrated that cancer patients presented higher concentrations of circulating CD31+ endothelial-derived and tumour cancer stem cell-derived CD133 + CD326- EVs, when compared to healthy volunteers. Furthermore, higher levels of CD133 + CD326− EVs showed a significant correlation with a poor overall survival. Additionally, proteomics analysis of EV cargoes demonstrated disparities in terms of protein content and function between circulating EVs in cancer patients and healthy controls. Overall, our data strongly suggest that blood circulating cancer stem cell-derived EVs may have a role as a diagnostic and prognostic biomarker in cancer.
Long-term (10-year) efficacy of finasteride in 523 Japanese men with androgenetic alopecia

Finasteride is a standard medical treatment for androgenetic alopecia; however, no long-term study of up to 10 years has been performed in Japan. Therefore, we evaluated the efficacy and safety of 1 mg/day finasteride in 532 Japanese men who were treated for androgenetic alopecia for 10 years. We performed subjective evaluations, using questionnaires administered to patients, in addition to the objective evaluation by doctors. The efficacy was assessed using the Norwood-Hamilton scale and modified global photographic assessment score, the standardized 7-point rating score using scalp photographs. For the Norwood-Hamilton classifications, stages IIa and IIv were combined as II, IIIa and IIIv were combined as III, IVa was combined as IV, and Va was combined as V. The proportions of patients with improvement (score ≥ 5) and prevention of disease progression (score ≥ 4) were 91.5% and 99.1%, respectively. The Norwood-Hamilton classification grading improved by approximately 1 grade from 3.35 ± 1.11 to 2.55 ± 1.30 after the 10-year treatment. The groups that showed Norwood-Hamilton: I/II/III and IV/V/VI/ VII at the first visit showed statistically significant differences in the modified global photographic assessment score at the 10-year treatment subjective evaluation (6.27 ± 0.62 vs 5.52 ± 0.78, P<0.001). Furthermore, the quantitative analysis of the objective evaluation using the questionnaire was also significantly different (P<0.001). During the study period, no serious adverse reaction was recognized. Long-term (10-year) treatment with 1 mg/day finasteride in Japanese men with androgenetic alopecia showed high efficacy in subjective and objective evaluations. *Correspondence to: Akio Sato, MD, PhD. Tokyo Memorial Clinic, 2F Yamaha Building, 2-16-7 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan, E-mail: drsato@ crux.ocn. ne.jp
Accuracy of McMurray’s test, the modified version, and joint-line tenderness in diagnosing chronic meniscal tear in the knee joint: A cross-sectional study

Background: Special clinical tests play an important role in physical examination and are thought to diagnose meniscal injury. Among the special tests, the original McMurray’s test, the modified version of the McMurray’s test, and joint-line tenderness are commonly used in practice. There is limited research that takes into consideration the time of injury in the diagnostic accuracy of such clinical test. Therefore, in chronic meniscal injury, the diagnostic accuracy of tests is unclear and questionable. The purpose of this study was to determine the most accurate clinical tests to diagnose a chronic meniscal injury. Methods: Fifty patients were enrolled in this cross-sectional study from January 2016 to June 2017. The inclusion criteria were patients 16 yr old or older who had a chronic knee injury of at least 6 mo. All patients underwent physical examination then arthroscopy performed by the same surgeon. Five statistical parameters were calculated based on the formula: accuracy (%), sensitivity (%), specificity (%), positive predictive value (PPV %) and negative predictive value (NPV %). Results: The mean age was 25.7 yr (range, 16-44 yr; SD 6.8 yr). The modified McMurray’s test had the highest sensitivity for both medial (36.36%) and lateral lesions (35.29%). It also had the highest NPV (64.10% medial and 73.17% lateral) and PPV (72.73% medial and 66.67% lateral), as well as the highest accuracy at 66% (medial) and 72% (lateral). The original McMurray’s test had the lowest sensitivity for lateral lesions (18.75%); however, it had the highest specificity for both lesions (92.59% medial and 91.18% lateral). Joint-line tenderness had the lowest specificity at 89.29% (medial) and 87.88% (lateral), the lowest accuracy for medial lesions (60%), and the same accuracy as the original McMurray’s test (68%) for lateral lesions. Conclusions: The results indicate that the original McMurray’s test, the modified version, and joint-line tenderness have overall low sensitivity and high specificity in diagnosing chronic meniscal tears. This study also highlights that the modified McMurray’s test had a higher accuracy than the original McMurray’s test and joint-line tenderness. However, in clinical practice these tests should be used in combination for more accurate diagnosis of chronic meniscal tears. Level of Evidence: Level III.