Miracle-dz/UniFAR-FTUs huggingface dataset:
Blockchain-Enabled iWellChain Framework Integration With the National Medical Referral System: Development and Usability Study

Background Medical referral is the transfer of a patient’s care from one physician to another upon request. This process involves multiple steps that require provider-to-provider and provider-to-patient communication. In Taiwan, the National Health Insurance Administration (NHIA) has implemented a national medical referral (NMR) system, which encourages physicians to refer their patients to different health care facilities to reduce unnecessary hospital visits and the financial stress on the national health insurance. However, the NHIA’s NMR system is a government-based electronic medical referral service, and its referral data access and exchange are limited to authorized clinical professionals using their national health smart cards over the NHIA virtual private network. Therefore, this system lacks scalability and flexibility and cannot establish trusting relationships among patients, family doctors, and specialists. Objective To eliminate the existing restrictions of the NHIA’s NMR system, this study developed a scalable, flexible, and blockchain-enabled framework that leverages the NHIA’s NMR referral data to build an alliance-based medical referral service connecting health care facilities. Methods We developed a blockchain-enabled framework that can integrate patient referral data from the NHIA’s NMR system with electronic medical record (EMR) and electronic health record (EHR) data of hospitals and community-based clinics to establish an alliance-based medical referral service serving patients, clinics, and hospitals and improve the trust in relationships and transaction security. We also developed a blockchain-enabled personal health record decentralized app (DApp) based on our blockchain-enabled framework for patients to acquire their EMR and EHR data; DApp access logs were collected to assess patients’ behavior and investigate the acceptance of our personal authorization-controlled framework. Results The constructed iWellChain Framework was installed in an affiliated teaching hospital and four collaborative clinics. The framework renders all medical referral processes automatic and paperless and facilitates efficient NHIA reimbursements. In addition, the blockchain-enabled iWellChain DApp was distributed for patients to access and control their EMR and EHR data. Analysis of 3 months (September to December 2018) of access logs revealed that patients were highly interested in acquiring health data, especially those of laboratory test reports. Conclusions This study is a pioneer of blockchain applications for medical referral services, and the constructed framework and DApp have been applied practically in clinical settings. The iWellChain Framework has the scalability to deploy a blockchain environment effectively for health care facilities; the iWellChain DApp has potential for use with more patient-centered applications to collaborate with the industry and facilitate its adoption.
Prevalence and Resistance Profiles of Enteropathogenic and Shiga Toxin-Producing Escherichia coli in Diarrheic Calves in Mashhad and Garmsar Districts, Iran

Background: Shiga toxin-producing Escherichia coli (STEC) strains are considered as one of the most important widespread food-borne pathogens, which cause diarrhea and life threatening diseases, such as hemolytic uremic syndrome, in humans. More recently, the STEC strains have also been incriminated to cause diarrhea and hemorrhagic colitis in calves; enteropathogenic E. coli (EPEC) also causes diarrhea in neonate animals. Objectives: This study aimed to study the prevalence and antibacterial resistance patterns of STEC and EPEC in fecal samples from diarrheic calves in Mashhad and Garmsar districts, Iran. Materials and Methods: A total of 115 fecal samples were collected from diarrheic animals, 75 from Mashhad and 40 from Garmsar districts. A total of 146 E. coli isolates were obtained from culture and subjected to multiplex-PCR assay targeting stx1, stx2, eaeA and ehly virulence genes. The antibacterial resistance patterns of the virulence-positive isolates were determined using disc diffusion method. Results: Eight samples (6.9%) carried the strains with positive results for at least one of the tested virulence genes. Five samples (4.3%) contained the stx-positive strains (STEC) and three (2.6%) carried the eaeA-positive and stx-negative strains, which were categorized as EPEC. In nine virulence-positive E. coli isolates, stx1 (n = 6) was the predominant virulence gene, followed by ehly (n = 5), eae (n = 4), and stx2 (n = 2). Antibacterial resistance patterns of virulence-positive isolates were also determined and nine resistance profiles were discriminated; higher rates of resistance were observed in isolates from Mashhad. Conclusions: This study indicated that other pathologic factors might play a more important role in calf diarrhea in the studied areas, but public health significance of these strains should not be overlooked.
Evaluation of Some Caries-Related Factors in the Saliva of 3-5 Year Old Children in Sari, Northern Iran

Background: Dental caries is one of the most common oral diseases in pre-school children. Several factors can affect caries process. Aim of this study was comparison of some of the chemical properties of saliva such as total antioxidant capacity, total protein, pH, nitric oxide level in caries free (CF), and caries active (CA) children. Materials and Methods This cross-sectional based study was designed with random selection of 80 healthy population including 40 CF and 40 CA children (3-5 years old) from several public kindergartens in Sari, Iranin 2019. Caries status was assessed using DMFT (Decayed/Missing/Filled Teeth) index according to WHO criteria. Un-stimulated saliva samples were collected from children in the morning. Then, several caries-related factors including total antioxidant capacity, nitric oxide, total protein concentration and pH were assessed in saliva samples. Data were analyzed using SPSS software version 16.0. Results: Significant higher total antioxidant capacity and total protein concentration were observed in the saliva of CA than in the CF children. On the other hand, nitric oxide level was markedly lower in CA samples. In addition, a decrease in pH of saliva was observed in CA children. Conclusion Based on the results, increase in the total antioxidant capacity and total protein as well as decrease in nitric oxide levels in the saliva of CA children can be considered as valuable evidence of dental caries occurrence among children.
Personality-Disordered Patients: Treatable and Untreatable

By reading, you can know the knowledge and things more, not only about what you get from people to people. Book will be more trusted. As this personality disordered patients treatable and untreatable, it will really give you the good idea to be successful. It is not only for you to be success in certain life you can be successful in everything. The success can be started by knowing the basic knowledge and do actions.
The benefits of student-led health promotion intervention

Purpose The benefits of a student-led mental health promotion intervention on World Mental Health day result in tangible learning benefits for those students. The event occurs within the students’ own university. The paper aims to discuss this issue. Design/methodology/approach This case study evaluates students’ experience on a mental health promotion intervention. This intervention was to enable students to experience running a health promotion intervention and develop their health promotion skills outside of their lectures. Students were recruited who had just completed a module on health promotion. Students had to plan and organise the intervention, which included involving other organisations and facilities both external and internal to the university. The experience was evaluated through the case study using as data collection a semi-structured interview. Findings Results indicated that students found the experience to be beneficial in deepening their understanding of health promotion, mental health awareness and in increasing their self-esteem. Limitations of this case study are in the argument for reproducibility of results, which is affected by the small number of students who took part. Research limitations/implications There are opportunities to develop this idea further and to broaden the availability of the initiative, enabling more students from diverse backgrounds to experience putting theory into practice. Originality/value To the best knowledge of the author, this study, although with limitations, provided a good understanding on how to develop health promotion skills within a university setting. The outcomes of this study are mainly applicable to a health studies course, educators of mental health promotion, university mental health support services and research related to this topic, especially on promoting mental health awareness and education.
Autoregulation of Renal Blood Flow During Ovine Pregnancy

Since the renal vasculature is vasodilated and the renal perfusion pressure (RPP) is reduced during pregnancy, the capacity to autoregulate renal blood flow (RBF) during pregnancy is unclear. Therefore, we assessed RBF auto-regulation in nonpregnant and pregnant sheep at RPP of 80, 75, 70, and 60 mmHg under control conditions, during amino acid infusion (SAP), and in sheep with nonfiltering kidneys in order to stress the normal feedback regulations of RBF. In nonpregnant animals, RBF was unchanged until RPP was reduced below 70 mmHg, but in pregnant animals the breakpoint occurred at 75-80 mmHg. The autoregulatory index (AI) was significantly higher in pregnant than in nonpregnant animals at all levels of RPP below 80 mmHg, indicating a greater impairment of RBF autoregulation during pregnancy. Amino acid infusion (SAP) elevated basal RBF similarly in all sheep and suppressed the autoregulatory curves of both groups, although to a greater extent in the pregnant sheep. Basal RBF was increased with nonfilte.
LES NEUROTOMIES PÉRIPHÉRIQUES DANS LE TRAITEMENT DE LA SPASTICITÉ FOCALISÉE DES MEMBRES

Introduite par Stoffel en 1912 pour le traitement du pied spastique equin, les neurotomies peripheriques consistent en une section partielle des collaterales motrices des muscles juges trop spastiques. Cette chirurgie peripherique est basee sur deux concepts : 1) Les reflexes spinaux et les muscles sont heterogenes et ont une organisation regionale intimement liee a leur role dans les conditions du mouvement volontaire. C'est la base du principe de spasticite focalisee et donc des traitements focaux de la spasticite; 2) La reinnervation des versants moteur et sensitif apres neurotomie n'est pas egale, la recuperation motrice survenant toujours alors que la reinnervation sensitive est beaucoup plus aleatoire, permettant un controle a long terme de la spasticite. Avant de realiser une neurotomie, une evaluation serieuse de l'indication est essentielle. De quel type de spasticite s'agit-il ? Quel est le but du traitement propose (confort, gain fonctionnel) ? S'inscrit-il dans un programme de reeducation clairement defini ? Le resultat de la chirurgie peut-etre teste par la realisation de blocs moteurs permettant de donner au patient une idee du resultat attendu. Il existe un grand nombre de neurotomie, en theorie autant que de nerfs moteurs, aussi bien au membre inferieur qu'au membre superieur. La neurotomie la plus frequemment pratiquee est la neurotomie tibiale pour le pied spastique equin.
Corneal Organ Culture Model for Assessing Epithelial Recovery After Surfactant Exposure

We previously reported the use of an ex vivo model of bovine corneal organ culture for predicting ocular irritation and evaluating acute chemical toxicity. Since the ability to recover after chemical exposure is a key parameter for assessing ocular toxicity of test chemicals, we sought to determine if cultured porcine cornea is able to recover after surfactant exposure and if functional recovery might be used as an ex vivo parameter for an ocular toxicity assay. Corneal chemical injury was created by placing a 7‐mm circular filter paper soaked in different concentrations of sodium dodecyl sulfate (SDS) on the center of porcine corneas for 2 minutes. The corneas exposed to surfactant with mild irritation (1% and 3% SDS, Draize score < 16.9) were able to recover from the initial damage, but no evidence of recovery was observed after exposure to surfactant with severe irritation (15% SDS, Draize score 59.2) as assessed by reestablishment of epithelial barriers. There was a concentration‐dependent increase in fluorescein retention in SDS‐exposed corneas. Furthermore, NF‐κB DNA‐binding activity was greatly altered after exposure to SDS in a concentration‐dependent manner. Our data suggest that functional corneal recovery after surfactant exposure correlates with known toxicity testing in vivo and may serve as a key endpoint for predicting ocular irritation of test chemicals and consumer products.
EPIDEMIOLOGY The Epidemiology of DSM-IVAlcohol Use Disorders amongst Young Adults in the Australian Population

Aim: The aim of the study was to examine the descriptive epidemiology of 12-month alcohol use disorders (AUDs) amongst young adults in the Australian general population. Methods: The 2007 National Survey of Mental Health and Well Being, a nationally representative household survey of 8841 Australian adults (16-85 years), assessed participants for symptoms of the most prevalent DSM-IV mental disorders. Young adults were over-sampled to provide detailed information on this age group. Results: 11.1% of young adults in the Australian population were diagnosed with an AUD. Compared with the rest of the young adult sample, young adults with AUDs were at greater risk of reporting another drug use disorder, an anxiety disorder, high levels of con- sumption, a medium or high score on the Kessler Psychological Distress Scale, and a moderate to severe score on the WHO Disability Assessment Schedule 2.0. Mental health services were rarely used by young adults with AUDs. Difficulties in differentiat- ing young adults diagnosed with abuse and those diagnosed with dependence with the criteria we used supported accumulating evi- dence questioning the validity of the abuse-dependence distinction. Conclusions: AUDs in young adulthood are prevalent and associated with comorbid psychopathology, risky levels of alcohol consumption and disability. Despite the clinical significance of AUDs in this age group, few young adults with these disorders use mental health services. In this age group, the proposed changes for DSM-V regarding the classification of AUD would seem helpful.
Transcatheter closure of congenital and acquired septal defects

Transcatheter closure of congenital and acquired septal defects has been performed for over 40 years. In several circumstances, it is now considered first in-line therapy over surgical closure. In this review, we summarize the indications to close congenital and acquired septal defects and briefly review the technique and devices used to repair such defects.
Occupational therapists’ shared decision-making behaviors with patients having persistent pain in a work rehabilitation context: A cross-sectional study

during arm elevation. The aim of this study is to investigate the effect of a specific closed-chain humeral head centering exercise on shoulder pain and function at workplace. Materials and methods 20 subjects with impingement symptoms have performed 5 dynamic humeral head centering sessions with the help of a specific device (Scapuleo, Europhyseo). Shoulder pain and function were evaluated at baseline, after the first exercise session (immediate effects) and after the last exercise session (intervention program effects). Shoulder pain was assessed by means of visual analog scale. Shoulder function was evaluated using analytic active range of motion tests (modified Yocum test; arm abduction) and functional test (repetitive pointing task). Results After the first training session, shoulder pain significantly decreased (P < 0.01). One-session effect was also observed on shoulder range of motion during both modified Yocum test (P < 0.001) and arm abduction (P < 0.01). Finally, all dependent variables were significantly improved at the end of the intervention program. Discussion The results of this study could be explained by humeral head centering improvement and rotator cuff muscles recruitment. Immediate and apparent beneficial effects induced by this intervention program fitted health and performance issues, essential for individuals as for companies. This study underlined the relevance of specific therapeutic exercises in work-related musculoskeletal management at the workplace.
Life course socioeconomic position and ankle-brachial index

1 ABRÉGÉ . 2 CHAPTER 1: INTRODUCTION.3 Objectives.6 CHAPTER 2: LITERATURE REVIEW.7 2.1. Cardiovascular disease.8 2.1. 1. Global burden of cardiovascular disease.8 2.1. 2. Risk factors for cardiovascular disease.9 2.1. 3. Development of atherosclerosis . 10 2.2. Socioeconomic position and cardiovascular disease . 12 2.2.1. Definition, conceptualization, and indicators of socioeconomic position . 12 2.2.2. The association between socioeconomic position and cardiovascular disease.16 2.2.3. Mediators of the association between socioeconomic position and cardiovascular disease . 18 2.3. Life course socioeconomic position and cardiovascular disease . 21 2.3.1. A life course approach to chronic disease epidemiology: background and frameworks . 21 2.3.2. The association between life course socioeconomic position and cardiovascular disease . 24 2.3.3. Measuring life course socioeconomic position: methodological concerns.26 2.4. Understanding the biological mechanisms between socioeconomic position and cardiovascular disease . 29 2.4.1. Focus on subclinical atherosclerosis . 29 2.4. 2. Indicators of subclinical atherosclerosis . 30 2.4. 3. The association between socioeconomic position and subclinical atherosclerosis . 33 2.4. 4. The association between life course socioeconomic position and subclinical atherosclerosis . 39 2.5. Summary . 42 CHAPTER 3: MANUSCRIPT.43 3.1. Abstract . 44 3.2. Introduction . 45 3.3. Methods . 46 3.4. Results . 51 3.5. Discussion . 57 3.6. Appendix for manuscript . 63 CHAPTER 4: CONCLUSION.64 4.1. Summary . 65
Effects of cardiopulmonary bypass perfusion temperature on perioperative renal function in adult patients undergoing cardiac surgery

Aims and objective The primary objective of this investigation was to study the effects of cardiopulmonary bypass (CPB) perfusion temperature on renal function parameters [serum creatinine, creatinine clearance, urine albumin, urine protein, and urine albumin/creatinine ratio (ACR)]. The secondary objective was to detect renal complications of CPB. Materials and methods This is a prospective longitudinal study of 30 adult patients (17 men, 13 women; mean age, 53.37 ± 16.02 years) who underwent valvular heart surgery [with or without coronary artery bypass grafting (CABG)]. Serum creatinine, creatinine clearance, urine protein, urine albumin, and urine ACR were collected during CPB (at 28 °C, 32 °C, and 37 °C) and postoperatively (at 12 hours, 24 hours, and 48 hours). Data were analyzed using one-way repeated-measures analysis of variance (ANOVA). A significant ANOVA was followed by a Bonferroni–Holm post hoc test. Results Although serum creatinine (p < 0.001) and creatinine clearance (p = 0.0016) underwent a significant ANOVA change (p < 0.001 and p = 0.0016, respectively) after CPB, there was no statistically significant change compared with their baseline values. Urine ACR showed a significant change at 28 °C (p < 0.01), 32 °C (p < 0.01), and 37 °C (p < 0.05) as compared with baseline values. No significant change in urine albumin was observed during CPB or up to 24 hours. A significant change occurred after 48 hours of CPB (p < 0.05). A significant increase in urine protein was noted after CPB at 12 hours (p < 0.01), 24 hours (p < 0.01), and 48 hours (p < 0.01). Overall, 12 (40%) patients had acute kidney injury (AKI). Ten (33.33%) patients had stage I AKI, one patient progressed to AKI stage II, and another to AKI stage III. Of the 10 patients who had stage I AKI, eight had complete recovery within 48 hours. Conclusions CPB with moderate hypothermia for valvular heart surgeries can be performed safely in patients with adequate renal functional reserve. The glomerular permeability across the Bowman’s capsule increases after CPB as evidenced by significant proteinuria at 12 hours and increased albuminuria at 48 hours after surgery. There is an increased risk of transient stage I AKI after CPB, from which patients recover within 48 hours.
INSOMNIA IS RELATED WITH PAIN, SOMATIC SYMPTOMS AND FUNCTIONAL STATUS IN PATIENTS WITH FIBROMYALGIA SYNDROME

Aims: Fibromyalgia Syndrome (FMS) is described as a central afferent processing disorder that might be associated with multiple physical and somatic symptoms. Sleep disturbances might be associated with the experience of somatic symptoms in FMS. The aim of this cross-sectional study is to evaluate the insomnia frequency, the relationship between insomnia and widespread pain, somatic symptoms, functional status in FMS. Materials and methods: Subjects diagnosed as FMS according to American College of Rheumatology (ACR) 2010 criteria were included. Patients were asked for Fibromyalgia Impact Questionnaire (FIQ), Fibrofatigue Scale (FFS) and Insomnia Severity Index (ISI). Correlations between the ISI scores and the FIQ, the FFS total and each item of the FFS, the Widespread Pain Index (WPI) scores and the sum of the Symptom Severity Scores (SS) were analysed. Data of the patients were compared in terms of those parameters according to insomnia levels determined by the ISI. Results: Ninety-one patients with FMS participated into the study. 76% of the patients had insomnia according to ISI. The ISI scores were found to be correlated with the WPI, the SS, total score of ACR 2010 criteria, the FIQ score, FFS total score, and some items of the FFS score, but not correlated with age, gender, symptom duration and education level. When patients were sub-grouped according to ISI, a significant statistical difference was found regarding FIQ, FFS, ACR 2010 total, WPI score and the SS score with respect from severe to moderate insomnia. Conclusion: In this study, insomnia is one of the major symptoms of FMS and correlated with other somatic symptoms. Sleep quality should be evaluated in every FMS patient.
Concentration of IgG antibodies against food allergens in patients with irritable bowel syndrome and healthy individuals Stężenie IgG przeciwko alergenom pokarmowym u pacjentów z zespołem jelita nadwrażliwego i osób zdrowych

Introduction: In recent years the hypothesis that irritable bowel syndrome (IBS) symptoms result from allergies or food intolerance which have not been identified has been gaining more and more supporters. Attempts are being made to find a connection between the symptoms identified in patients with IBS and food allergy, particularly IgG-dependent. The results obtained do not give a definite answer. Aim: Evaluation the usefulness of tests for immunoglobulin G (IgG) in patients with IBS against food allergens and the possible use of the obtained results for the introduction of an elimination diet. Material and methods: The study included 100 patients with IBS treated at the Gastrological Clinic of Brodnowski Regional Hospital in Warsaw. The control group consisted of 50 healthy individuals. IgG antibodies in the serum were tested against eight mixes of food allergens The concentration of antibodies was examined by an enzyme immunoassay test. Calculations were performed in Stata v.10. Results: Positive tests denoting the concentrations were found in more than 90% of patients with IBS. For the three tested mixtures of allergens, all the results were positive, and the remaining positive IgG titre occurred in at least 95% of the patients. In the control group results were similar. Conclusions: