Miracle-dz/UniFAR-FTUs huggingface dataset:
Knowledge of Antibiotic Use in College Students: A Quality Improvement Project

Aim: To evaluate college students' knowledge, attitudes, and beliefs about antibiotic use for simple viral infections, as well as determine if knowledge could be improved through an educational intervention and examine impacts on overall patient satisfaction.Background: Antibiotic resistance is a growing problem. College-aged students are at an increased risk for simple respiratory infections due to their close living conditions and poor knowledge of appropriate antibiotic use (Smith, Rigassio-Radler, Denmark, Haley, & Touger-Decker, 2012; Turner & Keller, 2015). Methods: Students (N = 44) age 19-25 seen at the college health center of a small, private Nebraska university presenting with symptoms of an upper respiratory infection (URI) were given a survey prior to seeing the healthcare provider. During the visit, providers reviewed an educational handout discussing appropriate antibiotic use for URIs and then gave the student a post-survey to complete.Results: Students' Basic Knowledge of antibiotics improved, p = . 1, Cohen's d = 0.41 as a result of the educational intervention, while changes in knowledge about Efficacy and Provider trust was mixed. Knowledge of correct use/misuse was high at pre, M = 1.95 and post M = 1.93. Conclusions: College-aged students benefit from additional education about antibiotics. Based on this project's findings, educational handouts have the potential to improve knowledge regarding antibiotics.
Lithium and Alzheimer’s Disease: Experimental, Epidemiological, and Clinical Findings

Alzheimer’s disease (AD) represents one of the greatest health-care challenges of the twenty-first century. Besides known pathologies such as intracellular accumulation of neurofibrillary tangles and extracellular deposition of amyloid-beta plaques, other factors, such as dysregulated GSK-3 activity, mitochondrial dysfunction, inflammation, and oxidative stress, have been shown to play a role in the pathogenesis of AD. Over the last two decades, the evidence accumulated for a neuroprotective effect of lithium, as an important mechanism of this ion in mood disorders, reflected by an increase in cerebral gray matter volume in lithium-treated subjects. Neurobiological mechanisms of lithium neuroprotective actions may also be relevant to the pathogenesis and treatment of AD, and they will be delineated. In most epidemiological studies, a negative association between lithium use and dementia has been shown, including two most recent papers regarding a concentration of lithium in drinking water. In this article, the results of initial studies using lithium in the treatment of dementia and showing some promise will also be presented. Therefore, considering the current paucity of treatments for the AD, further testing of lithium as a disease-modifying treatment in this illness may be warranted.
Effectiveness of Alma Alfatir water compress on breast engorgement among postantal women in Sree Mookambika Medical College Hospital at Kulasekharam, Kanyakumari District

Mother Hood is a very humanizing effect. Mother is placed at the level of God to provide love warmth and satisfy need of baby. Engorgement is due to milk excessively filling the breast together with fluid retention in the same area usually the breast feel full, hard, tight tender painful hot to touch. Alma alfatir water compress is traditional methods which reduce the breast engorgement and promote lactation. The main objective of the study to evaluate the effect of Alma alfatir compress on breast engorgement among post natal women. The research design selected for the study was quasi experimental pre test- posttest control design. purposive sampling technique was followed to obtain a sample of 60 post natal women (30 post natal women in experimental group and 30 post natal women in control group) pre test was done for both group by 6 point breast engorgement scale. Alma Alfatir water compress was given only to the experimental group at the interval 6 hours ( 2 times a day) for 3 days. The data was analyzed using descriptive and inferential statistics. The major findings of the study on effectiveness of Alma alfatir application for breast engorgement among post natal women showed the mean pre test score of the post natal women with breast engorgement before application of Alma Alfatir compress (5.60) is more than the mean post test score (2.63) after application of Alma Alfatir Compress independent “t” test shows that the “t” value 5.63 is higher than the table value. Hence Alma Alfatir compress was effective in breast in reducing the severity of breast engorgement (df 58, p < 0.05).
Genetic and observational evidence supports a causal role of sex hormones on the development of asthma

Introduction Males have a higher prevalence of asthma in childhood, whereas females have a higher prevalence in adolescence and adulthood. The ‘adolescent switch’ observed between sexes during puberty has been hypothesised to be due to fluctuating sex hormones. Robust evidence of the involvement of sex hormones in asthma could lead to development of therapeutic interventions. Methods We combine observational evidence using longitudinal data on sex hormone-binding globulin (SHBG), total and bioavailable testosterone and asthma from a subset of males (n=512) in the Avon Longitudinal Study of Parents and Children, and genetic evidence of SHBG and asthma using two-sample Mendelian randomisation (MR), a method of causal inference. We meta-analysed two-sample MR results across two large data sets, the Trans-National Asthma Genetics Consortium genome-wide association study of asthma and UK Biobank (over 460 000 individuals combined). Results Observational evidence indicated weak evidence of a protective effect of increased circulating testosterone on asthma in males in adolescence, but no strong pattern of association with SHBG. Genetic evidence using two-sample MR indicated a protective effect of increased SHBG, with an OR for asthma of 0.86 (95% CI 0.74 to 1.00) for the inverse-variance weighted approach and an OR of 0.83 (95% CI 0.72 to 0.96) for the weighted median estimator, per unit increase in natural log SHBG. A sex-stratified sensitivity analysis suggested the protective effect of SHBG was mostly evident in females. Conclusion We report the first suggestive evidence of a protective effect of genetically elevated SHBG on asthma, which may provide a biological explanation behind the observed asthma sex discordance. Further work is required to disentangle the downstream effects of SHBG on asthma and the molecular pathways involved.
Cost analysis of road traffic crashes in a tertiary hospital in Mpumalanga Province, South Africa

Abstract Background: Road traffic crashes (RTCs) are an important cause of injury and fatality in low-middle-income countries. In South Africa, they result in 7.8% of gross domestic product losses. The aim of the study was to estimate the cost of inpatient management of RTC injured patients in a tertiary hospital in Mpumalanga Province between 1 April 2015 and 31 March 2016. Methods: A cost analysis of patient care following a road traffic injury (RTI) was conducted using a mixed-costing approach. A retrospective review of hospital records was conducted to extract services consumed by patients during hospital admission between 1 April 2015 and 31 March 2016. Patient and financial records for the period 2015/2016 were used to obtain expenditure information. The bottom-up approach and top-down approach were used to calculate direct costs and indirect costs respectively. A sensitivity analysis was conducted to analyse how changes in resource use change the average costs. An average exchange rate of R13, 50 is equivalent to US$1 was used. Results: The majority of admissions were young males (72%) and those aged 20–34 years (53%). The patients were commonly injured in motor vehicle crashes (62%) sustaining head and neck injuries (32%) and fractures (23%). The total costs were R11,014,187 (US$815,865) with direct and indirect costs amounting to R5,995,872 (US$444,138) and R5,018,315 (US$371,207) respectively. The average cost per patient per day for RTIs was R256,382 (US$18,991). Conclusion: The economically active population and male gender were high risk groups with the main cost drivers being surgical sundries and medication. Direct management of patients accounted for high hospital costs. It is recommended that in addition to implementing a multipronged health promotion intervention to reduce the burden of RTCs, a further cost analysis using a time-motion study of patients admitted with RTIs be conducted to correctly analyse the costs incurred by the hospital.
Prediction of new onset atrial fibrillation in patients with acute pulmonary embolism: The role of sPESI Score.

OBJECTIVE Acute pulmonary embolism (APE) is a serious clinical situation and atrial fibrillation (AF) is the most common arrhytmia in clinical practice. The Pulmonary Embolism Severity Index (PESI) is an accepted risk stratification tool used to predict short term mortality in APE. The aim of this study was to evaluate the relationship between the PESI score and new-onset AF in patients with APE. METHODS The records of 869 APE patients admitted between May 2012 and December 2015 were evaluated retrospectively. The PESI score was calculated for every patient. Clinical variables associated with new-onset AF in APE were assessed after the exclusion of patients with hypertension, coronary or hemodynamically significant valvular heart disease, hepatic or renal dysfunction, chronic obstructive pulmonary disease, thyroid dysfunction, diabetes mellitus, sleep apnea, any history of inflammatory or infectious disease, or recent trauma. New-onset AF was detected in 42 (4.8%) patients. RESULTS Age, gender, systolic and diastolic blood pressure, heart rate, fasting glucose level, serum creatinine, left ventricle ejection fraction, tricuspid annular plane systolic excursion value, and pulmonary artery systolic pressure measures were not significantly different between patients with and without AF. New-AF patients demonstrated larger LVEDD and LAD dimensions (p <0.001 for both). The PESI score was higher in the new-onset AF group (93+-23 vs.75+-17; p <0.001). LVEDD, LAD, levels of uric acid, bilirubin, albumin, and troponin, and PESI score were univariate predictors of new-onset AF. CONCLUSION In patients with APE, the PESI score was positively correlated with new-onset AF. A PESI score greater than 82.50 may be useful to predict new-onset AF in these patients.
Magnetic resonance imaging findings in idiopathic sudden sensorineural hearing loss

Background The unpredictability in presenting signs and symptoms of idiopathic sudden sensorineural hearing loss (SSNHL) presents a notable diagnostic challenge for clinicians. Previous studies have confirmed the potentially important role of magnetic resonance imaging (MRI) in the diagnosis and prognostication of idiopathic SSNHL to guide definitive medical therapy, but correlations of these findings with outcomes remain controversial. Purpose To evaluate and identify magnetic resonance imaging (MRI) findings associated with idiopathic sudden sensorineural hearing loss (SSNHL). Material and Methods Sixty-eight patients with a documented diagnosis of idiopathic SSNHL and 20 controls underwent 1.5-T or 3-T MRI of the brain. Age, gender, ethnicity, associated co-morbidities, and audiometry findings were also recorded. Statistical analysis was performed to compare outcome measures between idiopathic SSNHL and control groups. Results The mean age of the cohort was 57 ± 17 years, with a male-to-female ratio of 1:1.1. MRI findings include 25.0% (P = 1.000) with chronic microangiopathic disease, 14.7% (P = 0.165) with temporal bone aberrations, 13.2% (P = 0.165) with facial and/or vestibulocochlear nerve complex changes, 11.8% (P = 1.000) with venous malformations, 8.8% (P = 0.104) with arterial malformations, and 8.8% (P = 0.184) with cerebral and/or brainstem parenchymal disease. Conclusion Arteriovenous malformations and central neurologic disease are not directly associated with idiopathic SSNHL on MRI. However, visualized signal changes of inner ear structures and facial/vestibulocochlear nerve complex support previously postulated theories, which include viral as well as inflammatory processes in the development of idiopathic SSNHL.
Physical activity and its determinant factors among medical students of Kerman University of Medical Sciences

Background : Exercise can play an important role in preventing chronic diseases. Given the key role of medical students on public health behaviors, the aim of the present study was to assess physical activity and factors influencing it in medical students of Kerman University of Medical Sciences. Methods: The present cross-sectional study was conducted on 600 medical students of Kerman University of Medical Sciences, using census method, over a six-month period. The valid and reliable self-administrate international physical activity questionnaire was used. Relevant data were fed into IBM SPSS Statistics for Windows, Version 20.0. The data were analyzed using chi-square test, ANOVA and multinomial logistic regression. Results: The level of physical activity was low in 275 (53.1%), moderate in 187 (36%), and vigorous in 57 (10.9%) of the participants. Students whose mothers or fathers had freelance jobs were 0.38 ( P =0.005) or 0.54 ( P =0.033) times less likely to have moderate physical activity compared with those whose mothers or fathers were retired. Students whose fathers had ‘lower than diploma’ education were 3.15 times more likely to have moderate physical activity ( P =0.003). Comparing vigorous to low physical activities, students whose fathers were in governmental jobs were 3.15 times more likely to have vigorous physical activity ( P =0.036). Also, students whose fathers had ‘lower than diploma’ education level were 0.17 times less likely to have vigorous physical activity ( P =0.004). Conclusion: Medical students in Iran are not in a good status in terms of physical activity. Considering the decisive role of parents in their children's attitudes towards physical activity, even in college, parent training seems necessary.
Cloves improve glucose, cholesterol and triglycerides of people with type 2 diabetes mellitus

Cloves (Syzygium aromaticum) have been shown to improve insulin function in vitro but the effects on people have not been determined. The objective of this study was to determine if cloves may be important in the prevention of type 2 diabetes mellitus (DM). Thirty‐six people, with type 2 DM were divided into 4 groups and given capsules containing 0, 1, 2 or 3 g of cloves/d for 30 d followed by a 10 d washout period. Since the responses to the three levels of cloves were not significantly different, the three groups were combined. Serum glucose decreased from 225 ± 67 to 150 ± 46 mg/dL, triglycerides decreased from 235 ± 63 mg/dL to 203 ± 86 mg/dL, serum total cholesterol decreased from 273 ± 78 mg/dL to 239 ± 47 mg/dL and LDL decreased from 175 ± 73 mg/dL to 145 ± 44 mg/dL after 30 d. Serum HDL was not affected by the intake of cloves. Following the 10 days of not consuming cloves, glucose, triglycerides, total and LDL cholesterol were all still significantly lower than at the onset of the study. There were no significant changes in the placebo group. In summary, consumption of capsules containing 1, 2 or 3 g of cloves/d for 30 d decreased risk factors of diabetes including glucose, triglycerides, total and LDL cholesterol with no changes in HDL concentrations. There were no significant differences among the 3 levels of cloves tested. These data suggest that intake of 1 to 3 g of cloves per day is beneficial for people with type 2 diabetes
Chemical composition, antimicrobial properties and toxicity of Jatropha curcas provenances from diverse origins.

This paper discusses probable therapeutic bases of 14 Jatropha curcas provenances based on their cytotoxicity, secondary metabolite profile and antimicrobial activity. Ethanolic extracts of Jatropha leaves and bark were subjected to antimicrobial and brine shrimp toxicity assays. The India 2 provenance showed a broad range of antibacterial activity against Escherichia coli, Staphylococcus aureus and Bacillus cereus. The rest of the provenances also revealed varying degrees of antibacterial activity against the three bacteria except for provenances India 1, Phil 6 and Tubang bakod, which did not show antimicrobial action. Brine shrimp lethality assay revealed high toxicity levels for the different Jatropha extracts. The presence of alkaloids, flavonoids, leucoanthocyanins, saponins, tannins and phenolics was detected through phytochemical analysis. The results of various assays indicate that Jatropha provenances have the potential for the development of novel compounds for the treatment of various ailments and infections. © 2012 Friends Science Publishers
Evaluation of time, method of sowing and varieties for table-purpose groundnut (Arachis hypogaea) under Island ecosystem.

A study was conducted during dry season of 2007–09 at Andaman and Nicobar Islands to evaluate the time, method of sowing and varieties for table-purpose of groundnut (Arachis hypogaea L.) under Island conditions. Experiment was laid out in split-plot design by assigning method of sowing (manual line sowing and manual dibbling) in main plot and 3 time of sowing (24 December, 7 January, 22 January) with 2 varieties (‘SG 99’ and ‘ICGS 76’) in sub-plots and replicated thrice. Growth, yield parameters and yield were not significantly influenced by method of sowing. However early sowing, 24 December registered significantly higher pod yield (3 979 kg/ha) which is at with sowing, ie in first week of January (3 838 kg/ha). Delayed sowing, 22 January gave significantly lower yield as terminal phase of crop growth coincided with onset of rainfall. Similarly, early sowing of 24 December recorded significantly higher net returns (Rs53 040/ha) and B: C ratio (2.5). Both the varieties ‘SG 99’ and ‘ICGS 76’ performed equally in terms of yield and economics. Higher energy ratio (25.8) and lower specific energy (3.3 MJ/kg) was recorded with December sowing.
Development and validation of risk-adjustment models for elective, single-level posterior lumbar spinal fusions.

Background There is a paucity of literature examining the development and subsequent validation of risk-adjustment models that inform the trade-off between adequate risk-adjustment and data collection burden. We aimed to evaluate patient risk stratification by surgeons with the development and validation of risk-adjustment models for elective, single-level, posterior lumbar spinal fusions (PLSFs). Methods Patients undergoing PLSF from 2011-2014 were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). The derivation cohort included patients from 2011-2013, while the validation cohort included patients from 2014. Outcomes of interest were severe adverse events (SAEs) and unplanned readmission. Bivariate analysis of risk factors followed by a stepwise logistic regression model was used. Limited risk-adjustment models were created and analyzed by sequentially adding variables until the full model was reached. Results A total of 7,192 and 4,182 patients were included in our derivation and validation cohorts, respectively. Full model performance was similar for the derivation and validation cohorts in both 30-day SAEs (C-statistic =0.66 vs. 0.69) and 30-day unplanned readmission (C-statistic =0.62 vs. 0.65). All models demonstrated good calibration and fit (P≥0.58). Intraoperative variables, laboratory values, and comorbid conditions explained >75% of the variation in 30-day SAEs; ASA class, laboratory values, and comorbid conditions accounted for >80% of model risk prediction for 30-day unplanned readmission. Four variables for the 30-day SAE models (age, gender, ASA ≥3, operative time) and 3 variables for the 30-day unplanned readmission models (age, ASA ≥3, operative time) were sufficient to achieve a C-statistic within four percentage points of the full model. Conclusions Risk-adjustment models for PLSF demonstrated acceptable calibration and discrimination using variables commonly found in health records and demonstrated only a limited set of variables were required to achieve an appropriate level of risk prediction.
Congenitally missing maxillary central incisor or solitary median maxillary central incisor?

Tooth agenesis is not a rare phenomenon. Most often, the tooth that shows agenesis is the maxillary lateral incisor or the third molars. Agenesis of maxillary central incisor is an extremely rare phenomenon. A case of congenital absence of maxillary central incisor in a 42-year-old, otherwise healthy individual is being presented. When one encounters a case, it is important that it is differentiated from the other serious form of the disease which is solitary median maxillary central incisor syndrome.
Development of an anterior cruciate ligament injury prevention programme based upon the biomechanics of cutting activities

Background: Anterior cruciate ligament injuries (ACL) frequently occur during cutting activities when fatigued or responding to the sporting environment. ACL injuries lead to profound short and long term consequences, making the prevention of ACL injuries critically important. However, the effect of fatigue and anticipation on cutting biomechanics is not well understood. Furthermore, there is limited research on the effects of interventions to improve the biomechanics of unanticipated cutting activities. Aims: To determine the effects fatigue and anticipation on the biomechanics of side and crossover cutting. Secondly, to develop and assess the efficacy of an exercise programme designed to improve cutting technique. Methods: Three studies determined the effect of a high intensity, intermittent exercise protocol (HIIP) on dynamic postural control, neurocognitive function and the biomechanics of the vertical drop jump, respectively. Two subsequent studies investigated the effects of the HIIP and anticipation on the biomechanics of crossover and side cutting, respectively. Finally, a randomised controlled trial assessed the effect of a dynamic core stability programme on the biomechanics of anticipated and unanticipated cutting. Findings: The HIIP had detrimental effects on dynamic postural control and neurocognitive function but not on vertical drop jump biomechanics. The combination of the HIIP and unanticipation did not increase the magnitude of biomechanical risk factors for ACL injuries during side and crossover cutting. However, unanticipation increased the magnitude of certain risk factors for ACL injuries, particularly related to trunk kinematics, during cutting. Although the dynamic core stability programme did not alter trunk kinematics, it reduced the magnitude of a small number of risk factors for ACL injuries during cutting, particularly during anticipated side cutting. Conclusion: The magnitude of biomechanical risk factors for ACL injuries is greater during unanticipated compared with anticipated cutting. A dynamic core stability programme has small, beneficial effects on cutting biomechanics.