Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Assessment of Nursing Care Regarding Prevention of Ventilator-associated Pneumonia in Neonates

Background: Ventilator-associated pneumonia (VAP) is the second common nosocomial infection in NICUs leading to some complications. Nurses are one of the main resources in health care that directly influence neonatal health care. Responsibility of most of preventive strategies related to VAP complications lies with nurses; therefore, nursing care should be assessed until the nurses show standard level of performance in hospitals. The aim of this cross-sectional study, conducted within 2015-2016, was to assess nursing care regarding VAP prevention in neonatal intensive care units (NICUs) in selected hospitals affiliated to Shahid Beheshti University of Medical Sciences.Methods: In this descriptive cross-sectional study, 100 observations of nursing care regarding VAP were selected by convenience method in NICUs of Mahdiyeh, Mofid, and Imam Hossein hospitals affiliated to Shahid Beheshti University of Medical Sciences within 2015-2016. The data collection tools included demographic information questionnaire and a developed checklist related to VAP prevention. The observations were assessed and documented with two sampling methods, including time and event sampling. The data were analyzed in SPSS software (version 16). Results: According to the results of the current study, the rate of compliance of nursing care with the standards for prevention of VAP in neonates under mechanical ventilation in NICU with developed standards was estimated at 62.81 percent.Conclusion: Authorities should pay more attention to nursing cares especially incompetent cares explained in this study to increase the health of hospitalized neonates, decrease complications, length of stay, and costs. Moreover, future research is needed to investigate the reasons of this incompetency.
nurses knowledge regarding weaning criteria of the patients with mechanical ventilation in a teaching hospital chitwan

Delays in weaning the patient from mechanical ventilation increase the number of complications and may lead to Introduction: Ventilator weaning is the process of gradually withdrawing artificial ventilation to the intubated patients for short or long time in critical care setting. Weaning patients from ventilator is complex and challenging task for nurses and knowing weaning criteria is most essential component for getting successful outcome for the patients with mechanical ventilation. Hence, this study was conducted to find out nurses’ knowledge regarding weaning criteria of the patients with mechanical ventilation.
“I’ve found my voice. I’ve found a sisterhood”: Qualitative evaluation of a web-based support group for women with HIV

Abstract This article presents a qualitative evaluation of a professionally moderated, psychoeducational, web-based support group for women with HIV, entitled Shared Journey. Nine in-depth interviews and 107 forum posts underwent thematic analysis. We asked participants to evaluate (1) the populations they felt would benefit from Shared Journey, (2) the unique features of the intervention, and (3) the outcomes they experienced from participating. Shared Journey may serve to support and translate knowledge to this population – especially those who are newly diagnosed, newcomers, and working for AIDS Service Organizations. Future implementations may empower participants and provide a space for safe disclosure rehearsal.
Cervical Sensorimotor Control Does Not Change Over Time and Is Not Related to Chronic Idiopathic Neck Pain Characteristics: A 6-Month Longitudinal Observational Study.

BACKGROUND Cervical sensorimotor control (CSMC) outcomes have been suggested to be important in the assessment of individuals with neck pain, despite the lack of consistent supporting evidence that CSMC skills are related to neck pain. OBJECTIVE The aim of this study was to investigate whether CSMC changes over time in individuals with chronic idiopathic neck pain and whether neck pain characteristics are associated with CSMC. DESIGN A longitudinal observational study was performed. METHODS A total 50 participants with chronic idiopathic neck pain and 50 matched participants who were healthy (controls) completed 7 CSMC tests (including 14 test conditions): joint position error, postural balance, subjective visual vertical, head tilt response, The Fly, smooth pursuit neck torsion, and head steadiness. Neck pain characteristics included pain intensity (visual analog scale), pain duration, and neck disability (Neck Disability Index). Linear mixed models were used to investigate whether any factors were associated with changes in CSMC. RESULTS Neck pain intensity was associated with 1 of 14 CSMC test conditions (balance with torsion and eyes open), and neck disability was associated with balance with eyes open and high-load head steadiness. Other factors, including sex, age, body mass index, physical activity levels, and neck pain duration, showed no association with CSMC. LIMITATIONS Although all other tests involved computerized data collection, the joint position error test was administered manually, introducing the risk of researcher bias. CONCLUSIONS The few associations between test conditions and neck pain characteristics were at best weak; hence, these are likely to be chance findings. These results suggest that CSMC may not be associated with improvement/worsening of chronic idiopathic neck pain, spawning debate on the clinical usefulness of CSMC tests.
Ultrasonographic Changes in Fascial Properties over Time after Myofascial Release

Recently, ultrasonic imaging modalities have been increasingly used to observe the locomotor apparatus. Furthermore, a high reliability has been reported for the measurements of fascial displacement using ultrasonic imaging and of muscle stiffness using ultrasonic elastography. This study aimed to clarify the ultrasonographic changes in fascial displacement and muscle stiffness induced by Myofascial Release (MFR). We divided 51 healthy adults (24 males and 27 females) into three groups: MFR, Static Stretching (SS), and control groups. The passive ankle joint dorsiflexion angle, isometric ankle joint flexor muscle strength, superficialand deep-layer fascial displacement, and muscle stiffness were each measured before, immediately after, and at 4 days after an intervention. All parameters in the MFR group showed significant changes immediately after and 4 days after the intervention compared with those at baseline. The MFR group also showed more significant changes in the dorsiflexion angle, fascial displacement, and muscle stiffness after 4 days compared with the SS group. Thus, MFR improves the viscoelasticity of the gelled matrix and eliminates the densification of collagen and elastin fibers, thereby smoothing fascial gliding. Consequently, this technique may help to regain the gliding ability of the fascia during joint movement and muscle contraction. In addition, it was also suggested that changes in physical function and fascial property due to MFR were significantly different after 4 days.
Discriminating progressive supranuclear palsy from Parkinson's disease using wearable technology and machine learning.

BACKGROUND Progressive supranuclear palsy (PSP), a neurodegenerative conditions may be difficult to discriminate clinically from idiopathic Parkinson's disease (PD). It is critical that we are able to do this accurately and as early as possible in order that future disease modifying therapies for PSP may be deployed at a stage when they are likely to have maximal benefit. Analysis of gait and related tasks is one possible means of discrimination. RESEARCH QUESTION Here we investigate a wearable sensor array coupled with machine learning approaches as a means of disease classification. METHODS 21 participants with PSP, 20 with PD, and 39 healthy control (HC) subjects performed a two minute walk, static sway test, and timed up-and-go task, while wearing an array of six inertial measurement units. The data were analysed to determine what features discriminated PSP from PD and PSP from HC. Two machine learning algorithms were applied, Logistic Regression (LR) and Random Forest (RF). RESULTS 17 features were identified in the combined dataset that contained independent information. The RF classifier outperformed the LR classifier, and allowed discrimination of PSP from PD with 86 % sensitivity and 90 % specificity, and PSP from HC with 90 % sensitivity and 97 % specificity. Using data from the single lumbar sensor only resulted in only a modest reduction in classification accuracy, which could be restored using 3 sensors (lumbar, right arm and foot). However for maximum specificity the full six sensor array was needed. SIGNIFICANCE A wearable sensor array coupled with machine learning methods can accurately discriminate PSP from PD. Choice of array complexity depends on context; for diagnostic purposes a high specificity is needed suggesting the more complete array is advantageous, while for subsequent disease tracking a simpler system may suffice.
Direct and Indirect Inhibition of the Mediodorsal Thalamus Affects Seizure Propagation and Cognition

Temporal lobe epilepsy (TLE) is one of the most common neurological disorders, and is characterized by spontaneous, recurrent seizures. Seizures in TLE do not propagate randomly, but instead follow anatomically constrained pathways; some of these pathways are substrates for normal cognitive processes. Of particular interest are the interconnections between limbic brain regions (e.g., the amygdala), and cortical regions (e.g., the frontal cortex). These structures are anatomically linked by the mediodorsal thalamus (MD), are engaged by seizures, and are crucial for normal cognition. While separate manipulations of each of these regions indicate that they are necessary for limbic seizure propagation, the role of discrete projection pathways between these regions has not been studied. Further, the nucleus reticularis of the thalamus (nRT) exerts inhibitory tone on the MD, modulating its activity. The MD can then be inhibited indirectly by activation the nRT. Therefore, the overarching goal of these studies were to assess if 1) inhibition of the MD, direct or indirect, via the nRT, can attenuate limbic motor seizures and if 2) inhibition of the MD will result in cognitive deficits. In this dissertation, chemogenetic inhibition of the MD attenuated both amygdala and hippocampal kindled seizures. The projection from the BLA to the MD equally attenuated seizures in both models. Further, the projection from the MD to different regions of the frontal cortex resulted in varying amounts of attenuation of amygdala
Is Research on Transgender Children What It Seems? Comments on Recent Research on Transgender Children with High Levels of Parental Support

Recent research on transgender children who have had support from their parents for their transitioning has concluded that their mental health is virtually no different than that of nontransgender children. Such research has been extensively cited, over 370 times in the past three years. Most of the hundreds of reviews received the stated results of the studies with little caution. However, the research featured numerous statistical errors and omissions, the implications of which would likely lead neutral observers to conclude that the mental health of transgender children, even when supported by their parents, was poorer than that of the groups of control children. In particular, levels of anxiety as reported by both parents and their transgender children appear to be significantly higher, and the transgender children’s reports of self-worth appear to be significantly lower. Although reports regarding depression are not as significantly different, the effect sizes were generally in a similar direction as the other outcomes, being less favorable for the transgender children. Such issues highlight the need for careful examination of statistical research, even when published in highly regarded medical journals. As with other research, findings from the early stages of controversial research may often be premature. Further research is needed to explore factors underlying these results. Summary: Some scholars have believed that if transgender children were supported by their parents before the children reached puberty, the generally higher rates of mental illness experienced by many transgender persons might be prevented or alleviated. Dr. Kristina Olson of the Department of Psychology at the University of Seattle was the first scholar to have studied groups of transgender children who were being supported by their parents and to have compared them to a control group of children and to siblings of the same transgender children. Her conclusion was that there were minimal, if any, differences in anxiety, depression, and self-worth among the groups of children; her research has since been cited extensively as having found just that. We reanalyzed her raw data and found that, to the contrary, the transgender children, even when supported by their parents, had significantly lower average scores on anxiety and self-worth. Often, a significantly higher percentage of transgender children, compared to controls, featured preclinical or clinical levels of anxiety. Parental support of transgender children may temporarily reduce levels of poor mental health for some transgender children, but it does not appear to eliminate those problems for all transgender children. Our findings should serve as a warning against accepting research at a surface level, which can lead to acceptance of invalid information and pursuit of ineffective interventions.
Small vessel disease is associated with an unfavourable outcome in stroke patients on oral anticoagulation

Introduction Cerebral small vessel disease is an important cause for both ischaemic stroke and intracranial haemorrhage. To date, knowledge on the impact of small vessel disease on the clinical course in stroke patients treated with oral anticoagulation for atrial fibrillation is limited. Patients and Methods Registry-based prospective observational study of 320 patients (aged 78.2 ± 9.2 years) treated with anticoagulation following atrial fibrillation stroke. Patients underwent standardised magnetic-resonance-imaging assessing measures of small vessel disease, including cerebral microbleeds and white matter hyperintensities. Median follow-up was 754 (interquartile range = [708–828]) days. Using adjusted logistic and Cox regression, we assessed the association of imaging measures with clinical outcome including recurrent ischaemic stroke, intracranial haemorrhage and death and assessed disability (modified Rankin Scale). Results Overall, recurrent ischaemic stroke was more common than intracranial haemorrhage (22 versus 8, respectively). Cerebral microbleeds were related to an increased risk of the composite endpoint (ischaemic stroke, intracranial haemorrhage, death: odds ratio (OR) 2.05, 95% confidence interval (CI) 1.27–3.31; P = 0.003), as were white matter hyperintensities (OR 2.00, 95%CI 1.23–3.27, P = 0.005). This was also true in time-to-event analysis (cerebral microbleeds: HR 2.31, 95%CI 1.39–3.52; P < 0.001; white matter hyperintensities: HR 1.99, 95%CI 1.20–3.17; P = 0.007). Both measures were associated with an increased risk for recurrent ischaemic stroke (cerebral microbleeds: HR 4.42, 95%CI 1.07–18.20; P = 0.04; white matter hyperintensities: HR 5.27, 95%CI 1.08–25.79, P = 0.04) and intracranial haemorrhage (cerebral microbleeds: HR 2.43, 95%CI 1.04–5.69; P = 0.04; white matter hyperintensities: HR 2.57, 95%CI 1.11–5.98, P = 0.03). Furthermore, confluent white matter hyperintensities were associated with increased disability (OR 4.03; 95%CI 2.16–7.52; P < 0.001) and mortality (HR 1.81, 95%CI 1.04–3.14, P = 0.04). Discussion and conclusion In atrial fibrillation stroke patients treated with oral anticoagulation, small vessel disease is associated with an unfavourable outcome. The presence of microbleeds indicated a risk higher for recurrent ischaemic stroke than for intracranial haemorrhage.
Gender Differences in Response to Alcohol Use Disorder Treatment: A Systematic Review

Men and women might respond differently to some treatments for alcohol use disorder. If so, this would be important to consider when selecting treatment. The purpose of this systematic review was to synthesize evidence for gender differences in effects of treatments. While researchers did not identify systematic differences across studies, a paucity of reporting on treatment effects according to gender hindered analysis.
Comparison of Time and Cost Savings Using Different Cost Methodologies for Patient-Specific Instrumentation vs Standard Referencing in Total Ankle Arthroplasty

Background: Patient-specific 3-D printing cutting blocks (PSI) have been used instead of traditional intramedullary cutting guides. We hypothesized that PSI would lead to significantly decreased operating room (OR) time and significant cost savings to our institution with noninferior radiographic outcomes and no difference in expected vs actual implant size when compared with standard referencing (SR). Methods: Patients who had undergone total ankle replacements at our institution from 2013 through 2016 were included in the study. Associations between demographic variables and postoperative alignment in the SR vs PSI group were calculated using the Wilcoxon rank-sum test and the intraclass correlation coefficient. The cost of the operation was calculated using both an institutionally based fixed cost of OR time and using Time Driven Activity Based Cost (TDABC) accounting. A total of 43 patients were included in the study, 13 in the SR group and 30 in the PSI group. Results: Operative time (168 vs 137 minutes) and tourniquet time (123 vs 113 minutes) were significantly lower in the PSI vs the SR group. PSI predictions were accurate 100% of the time for tibial components and 83% of the time for talar components. Average costs of TAA using PSI were significantly reduced by $7597.00 when using traditional OR accounting, whereas PSI was $836.00 more expensive on average using TDABC accounting. Conclusion: Further research is needed to determine the cost-effectiveness of PSI vs SR in TAA; however, it does appear to save time intraoperatively. The long-term effect on clinical outcomes requires further study. Level of Evidence: Level III, case-control study.
Effect of Sport Activity on Elderly Hypokinetic Trend and Risk

The purpose of the present study was to measure hypokinetic trend and risk status of the elderly who active in five kinds of sport; and to describe the difference of training effect of five kinds of sport to elderly hypokinetic trend and risk. The expost facto method was used for this study. Subjects who participated in the study were seventy-four elderly people, and their five respective sport health club situated in Bandung, id Est lawn tennis (12), walking (16), table tennis (13), gymnastic (15), badminton (15). The instrument used to measure sport activity refers to the physical fitness test proposed by the Center for Study and Development of Sports Science and Technology Office of the Minister of Youth and Sports, and a interviewed questionnaire for hypokinetic. Hypokinetic trends measurement with 15 questions, risk of hypokinetic with 10 questions. SPSS 2014 was used for data analyze. The result of this study was: 1. The hypokinetic status rank according to gain score was: badminton, lawn tennis, gymnastic, walking, table tennis, all of them were on good status; 2. The risk status of ache because of hypokinetic according to gain score was: badminton, lawn tennis, table tennis, gymnastic, walking. Conclusions: The activity of five kinds of sport give good effect as an effort to overcome less movement quality and give very good effect as an preventif effort to hypokinetic trend and risk. Keywords—sport activity; health and physical fitness; hypokinetic trend and risk
PERINEAL CARE AND OUTCOMES IN A BIRTH CENTER

ABSTRACT Objective: to analyse the perineal outcomes in childbirth and post-partum perineal care in a freestanding birth centre. Method: a cross-sectional study, with data collection performed in the women’s birth records forms from Casa Angela, a freestanding birth centre, São Paulo, Brazil, in 2016-2017 (n=415). The following data was analysed: occurrence and perineal tear degree; maternal, neonatal and birth care-related variables; perineal suture prevalence; complications in wound healing and natural methods on perineal care. Data were subjected to descriptive, inferential and multiple analyses. Results: in 11.8% of women, the perineum was kept intact, 61.9% had spontaneous first-degree tear and 26.3% had second-degree tear. The variables related to the occurrence and higher spontaneous degree tears were maternal age and second period of childbirth >2 hours. The protective factors against the occurrence and higher degree tears were number of previous vaginal childbirths and maternal position different from vertical during childbirth. Perineal suture was performed in 16.0% and 70.6% of women with spontaneous first- and second-degree tears, respectively. The main perineal complications after birth were edema (53.6%) and pain (29.4%); and the perineal suture increased the chance for these complications (OR=2.5; 95%CI 1.5-4.3). Perineum icepack compress was used in 53.8% of women during post-partum period. Conclusion: maternal and health-care related factors were associated to the prevalence and degree of spontaneous perineal tear. First-degree spontaneous perineal tears were prevalent and sutured in a low number of women. There were more complications in the wound healing process when the perineal suture was performed, regardless the tear degree. The number of natural methods in post-partum perineal care was higher than the use of medicines.
Whether Hypertensive Diseases in Pregnancy are Associated with Emotional Stress

Objective : Stress plays important role in effecting the cardiovascular disease and most of the risk factors with hypertensive disease in pregnancy [HDP] is caused by stress. Main objective of the study is to find connection between stress and risks for HDP during pregnancy. Place and duration of study : Obstetrics and Gynaecology Department Rajab Tayyep Erdogan Indus Hospital, Muzaffargerh. From August 2018 to August 2019. Material and method: A controlled examination contrasting obstetrical and psychosocial was conducted by 724 patient and 879 matched control for ages, equality, and educational level. Results: Emotional stress during pregnancy was linked with 1.6 times increase risk for hypertension during pregnancy. Conlusion : Psychosocial involvement to decrease emotional stress during the period of pregnancy can aid to reduce the risk to emerge HDP. Keywords: Hypertensive, Pregnancy, Emotional Stress DOI : 10.7176/JMPB/60-04 Publication date :October 31 st 2019
A COMPARATIVE STUDY OF CARDIOVASCULAR RESPONSE IN TWO ACUTE SUBMAXIMAL TREADMILL EXERCISE TESTS AND ITS CORRELATION WITH ANTHROPOMETRIC VARIABLES

Aim: (i) To assess and compare the cardiovascular response in two sub-maximal exercise tests. (ii) to see correlation between cardiovascular response and anthropometric variables. Method: 125 males 18-25 years underwent first three stages of the original Bruce protocol in one session and exercise according to Treadmill jogging test in another session in randomised order. Heart rate, blood pressure and ECG were recorded before, during and after taking the treadmill test. Results: During the exercise heart rate and systolic BP rose and diastolic BP fell in both the tests. Correlation analysis showed highly significant positive correlation between BMI and pre-exercise systolic BP, post-exercise heart rate and post-exercise systolic BPin both the tests. ECG showed no significant ST/Tor rhythm changes during or after the exercise. Conclusion: Heart rate and BPchanges were more in Bruce submaximal exercise test as compared to treadmill jogging test. Higher BMI was found to be correlated with higher resting systolic BP, higher post-exercise heart rate as well as higher post-exercise systolic BP.