Miracle-dz/UniFAR-FTUs huggingface dataset:
Students’ experiences of using the partograph in Kenyan labour wards

Background: Previous research has demonstrated the likely benefits of partograph use in low-resourced settings. However, the challenges of completing a partograph are also reported. The objective of this study was to examine students’ views and experiences of partograph use to gain understanding of the realities of using this tool in the labour ward. Methods: In a qualitative study, 51 student nurses, undertaking their maternity placement at a university in Nairobi, Kenya, participated in five focus group discussions. Data were audio recorded, transcribed verbatim and analysed thematically. Results: Four main themes emerged from the analyses: challenges to ‘doing the right thing’; theory-practice disconnectedness; negative role models; and retrospective recording. Conclusions: The results provide insight into the challenges faced by students when practising in the labour ward environment. A more effective approach to partograph training and implementation should be adopted to support students. However, st.
Evolution and biogeography of Pleurophyllum (Astereae, Asteraceae), a small genus of megaherbs endemic to the subantarctic islands.

PREMISE OF THE STUDY The abundance of fossils in Antarctica suggests this continent was a center of diversification and a corridor for migration for many austral plant groups until the late Tertiary and may have played a pivotal role in shaping plant distributions in the southern hemisphere. Although the Antarctic flora was largely erased by glaciation during the Pleistocene, at least some Antarctic plant species found refuge on the subantarctic islands. METHODS We used independent and combined analyses of ITS, ETS, trnK, and trnL DNA sequences to infer phylogenetic relations in Pleurophyllum, a small genus of three species that are endemic to the subantarctic islands of Australia and New Zealand. The inferred phylogeny provided a framework to reconstruct the origin and patterns of diversification in the genus. KEY RESULTS We summarize support for the hypothesis that Pleurophyllum survived episodes of Pleistocene glaciation in the subantarctic islands and that its sisters dispersed northward in response to glacial advance. CONCLUSIONS The distinctive flora of the subantarctic islands includes some of the last remnants of a once-diverse Antarctic flora. These plants may still retain distinctive features of their ancestors. Studies of endemic plants such as Pleurophyllum are the key to resolving this puzzle.
Lung Hyperinflation and Its Reversibility in Patients with Airway Obstruction of Varying Severity

ABSTRACT The natural history of lung hyperinflation in patients with airway obstruction is unknown. In particular, little information exists about the extent of air trapping and its reversibility to bronchodilator therapy in those with mild airway obstruction. We completed a retrospective analysis of data from individuals with airway obstruction who attended our pulmonary function laboratory and had plethysmographic lung volume measurements pre- and post-bronchodilator (salbutamol). COPD was likely the predominant diagnosis but patients with asthma may have been included. We studied 2,265 subjects (61% male), age 65 ± 9 years (mean ± SD) with a post-bronchodilator FEV1/FVC <0.70. We examined relationships between indices of airway obstruction and lung hyperinflation, and measured responses to bronchodilation across subgroups stratified by GOLD criteria. In GOLD stage I, vital capacity (VC) and inspiratory capacity (IC) were in the normal range; pre-bronchodilator residual volume (RV), functional residual capacity (FRC) and specific airway resistance were increased to 135%, 119% and 250% of predicted, respectively. For the group as a whole, RV and FRC increased exponentially as FEV1 decreased, while VC and IC decreased linearly. Regardless of baseline FEV1, the most consistent improvement following bronchodilation was RV reduction, in terms of magnitude and responder rate. In conclusion, increases (above normal) in airway resistance and plethysmographic lung volumes were found in those with only minor airway obstruction. Indices of lung hyperinflation increased exponentially as airway obstruction worsened. Those with the greatest resting lung hyperinflation showed the largest bronchodilator-induced volume deflation effects. Reduced air trapping was the predominant response to acute bronchodilation across severity subgroups.
Role of left ventricular biopsy in the management of heart disease.

More than 50 years after the first description of transvenous endomyocardial heart biopsy (EMB),1 the role of EMB remains controversial. EMB is often essential for the diagnosis of allograft rejection and specific forms of native myocardial disease, including amyloidosis and giant cell myocarditis,2 yet expert consensus for the utility of EMB in more common scenarios is lacking. For example, a 2013 position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases recommends heart biopsy be performed for all cases of suspected myocarditis, including most acute and chronic dilated cardiomyopathy.3 In contrast, the “2013 ACCF/AHA Guideline for the Management of Heart Failure” recommends that “endomyocardial biopsy should not be performed in the routine evaluation of patients with heart failure. ” (class of recommendation III). 4 The European Society of Cardiology Working Group and the American College of Cardiology Foundation/American Heart Association recommendations are both based on expert opinion (level of evidence C). Article see p 1531 Most authorities in the field agree on the unique ability of EMB to diagnose specific viral heart infections and distinguish prognostically valuable histological patterns such as sarcoidosis or lymphocytic myocarditis.5,6 Lymphocytic myocarditis is a histological biomarker that predicts both successful bridging to recovery after left ventricular (LV) assist device placement in adults7 …
The Psychopathology of Parents of Children and Adolescents with Obsessive-Compulsive Disorder

Objective: Our purpose was to determine the rates of psychopathology in parents of children and adolescents with obsessive-compulsive disorder (OCD) and compare these with that found in parents of children with learning disorders of reading and written expression. Method: Thirty-one children with OCD, aged 8–15 years, and their parents (n = 62), aged 43–48 years, were studied and compared to 30 children with learning disorders, aged 7–16 years, and their parents (n = 58), aged 40–46 years. In order to investigate the parental psychopathology, the Symptom Checklist-90-R (SCL-90-R), the State and Trait Anxiety Inventory and the Yale-Brown Obsessive-Compulsive Scale were administered. The psychopathology of children was examined through the Schedule for Affective Disorders and Schizophrenia for school-aged children and other instruments. Results: Both fathers and mothers of the probands differed from the controls in a variety of symptoms (i.e. anxiety, depression, obsessions, etc.). Both parents had increased severity of OC symptomatology in comparison to the controls. In addition, the probands’ fathers had severe OC symptomatology at a higher percentage than the mothers and respective controls. Conclusion: The elevated scores of the parents of children with OCD in some SCL-90-R subscales can be perceived as an index of heightened psychopathology. More fathers in the OCD group, compared to mothers and controls, were found to have OC symptoms in the SCL-90-R and increased severity of OC symptoms on the Yale-Brown Obsessive-Compulsive Scale. The last finding requires further study. Parental psychopathology in children with OCD needs to be addressed clinically.
National and state trends in quality of care for acute myocardial infarction between 1994-1995 and 1998-1999: the medicare health care quality improvement program.

BACKGROUND National efforts have focused attention on quality of care, but relatively little is known about whether, and to what extent, improvement has occurred during this recent period. Furthermore, the variability of the recent change over time is not known. METHODS We sought to determine national and state trends in quality of care for Medicare patients hospitalized with acute myocardial infarction (AMI) between 1994-1995 (n = 234754 discharges) and 1998-1999 (n = 35713 discharges) as part of the Centers for Medicare & Medicaid Services (CMS) National AMI Project. We assessed change in evidence-based, guideline-recommended processes of care. RESULTS Nationally, among patients without contraindications to therapy, discharge beta-blocker prescription increased by 20.5 percentage points (50.3% to 70.7%); early administration of beta-blocker increased by 17.4 percentage points (51.1% to 68.4%); discharge angiotensin-converting enzyme inhibitor prescription for systolic dysfunction increased by 8.0 percentage points (62.8% to 70.8%); early administration of aspirin increased by 6.6 percentage points (76.4% to 82.9%); and aspirin prescribed at discharge increased by 5.6 percentage points (77.3% to 82.9%) (P<.001 for all categories). Smoking cessation counseling decreased by 3.6 percentage points (40.8% to 37.2%; P<.001). Rates of acute reperfusion therapy did not significantly change (59.2% to 60.6%; P =.35). The median time from hospital arrival to initiation of thrombolytic therapy decreased by 7 minutes (P<.001); and the median time from hospital arrival to initiation of primary percutaneous transluminal coronary angioplasty decreased by 12 minutes (P =.09). CONCLUSIONS During this 4-year period, quality of care for AMI improved, but substantial variation was observed at both time points. While meaningful population-based improvement has been achieved, ample opportunities for improvement exist. Further work is required to elucidate the strategies associated with improvements in quality of care.
Once weekly treatment with epoetin-β

Studies have shown that both intravenous (i.v.) and subcutaneous (s.c.) administration of epoetin-b therapy are effective and well tolerated in the treatment of renal anaemia; however, the s.c. route provides enhanced efficacy with a lower dose compared with the i.v. route and it is more cost-effective. Epoetin dosing frequency is an important issue for health care professionals and patients. Recent studies have shown that epoetin-b administered once weekly and once every 2 weeks can maintain stable target haemoglobin and haematocrit levels in dialysis patients. Such reduced dosing frequencies may improve patient satisfaction and compliance with treatment, and encourage patients to self-administer. Furthermore, less frequent dosing administration would be associated with economic benefits in terms of reduced nursing time in the clinic or out-patient setting. Where this is clinical practice, fewer injections and visits to the clinic should also improve patients’ quality of life. A range of effective dosing regimens with epoetin-b administered via either pre-filled syringes, multidose vials or injector pens allows physicians to tailor treatment to an individual patient’s preference.
The effectiveness of occupational therapy and physiotherapy in multiple sclerosis patients with ataxia of the upper limb and trunk

Objective: The aim of the study was to evaluate the effectiveness of therapy intervention in reducing impairment and disability due to upper limb and trunk ataxia in chronic multiple sclerosis (MS). Design: The change in performance scores of two patient groups - an inpatient group who received two weeks' therapy intervention and an outpatient 'control' group awaiting a similar admission - were compared. Subjects: Thirty-seven (out of a total of 62) patients with clinically definite or laboratory-supported definite MS, with ataxia of the upper limbs and/or trunk, and who had stable or slowly progressive disease. Intervention: The (inpatient) treatment group (n = 28) received eight half-hour sessions each of occupational therapy and physiotherapy over eight consecutive working days. Treatment approaches used were aimed at improving dynamic posture and appropriate adaptation of the environment. The control group (n = 9) received no intervention. Assessments: Patients were assessed the day before therapy began and the day after it ended: the control group were assessed at the same (two-week) interval. Assessments used included the Jebsen Test of Hand Function (JTHF), the Kurtzke Functional Systems Scale (FSS) and Expanded Disability Status Scale (EDSS), the Northwick Park Index of activities of daily living (NPI), and patient and assessor visual analogue scales. Assessors were independent of patient treatment. Results: There were no significant differences between the two groups at entry to the study with respect to age, sex and scores on the FSS (exception bowel function). The NPI scores were not significantly different except for walking and feeding, whereas the control group was slightly better (Mann-Whitney U-test; p = 0.048; p = 0.037). No significant difference between the change scores of the two groups was found on the JTHF and FSS neurological scores. The treatment group showed significant improvement compared to controls in the NPI scores and on the self and assessor visual analogue scales. Conclusion: The findings support the clinical impression that therapy used to improve dynamic posture and methods of performing functional tasks can result in improvement of functional ability in patients with MS where spontaneous improvement would not otherwise be expected.
The complete mitochondrial genome of the Acipenser schrenckii (Acipenseridae: Acipenser)

Abstract The Acipenser schrenckii is an ancient freshwater Chondrostei species, which is mainly distributed in Amur River in China and Russian. The complete mitochondrial genome of A. schrenckii was obtained for the first time in this study. The circular genome (16,548 bp in length) consists of 37 typical animal mitochondrial genes (13 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes) and 1 control region. Overall base composition of the complete mitochondrial DNA was 30% A, 24% T, 29.4% C and 16.5% G with AT (54%).
Cardiac tamponade, a clinical challenge

Pericardial effusion and cardiac tamponade can develop in patients with virtually any condition that affects the pericardium, including post-pericarditis, malignancies, chronic renal failure, thyroid disease, autoimmune disease, traumatic and idiopathic causes. Symptoms and signs lack both sensitivity and specificity. Appropriate diagnostic arcades can minimize the associated morbidity and mortality. Cardiologist should be aware of the physiological and clinical aspects of the disease spectrum.
The impact of human-computer interaction-based comprehensive training on the cognitive functions of cognitive impairment elderly individuals in a nursing home.

BACKGROUND Given the increasing prevalence of dementia, any intervention that can effectively slow the deterioration of cognitive function is of great importance. OBJECTIVE This study investigated the efficacy of a human-computer interaction-based comprehensive cognitive training program in cognitively impaired elderly individuals living in a nursing home. METHODS All subjects, who were aged ≥70 years and had cognitive impairment, were randomly allocated to an intervention group (n = 19) or a control group (n = 14). The intervention group received human-computer interaction-based comprehensive cognitive training for 24 weeks. Neuropsychological examinations were conducted before and after this period. The intervention group was subdivided into two groups according to the scores of global cortical atrophy (GCA) to evaluate the impact of training effectiveness on GCA. RESULTS After 24 weeks, neither group showed a significant change compared with baseline cognitive examinations. However, there was a tendency for greater improvement in memory, language, and visuospatial abilities for the intervention group as compared with controls. Patients with mild cognitive impairment showed improvements in language and visuospatial capacity, while patients with dementia showed improvements in attention/orientation, memory, language, and fluency. However, none of these findings were statistically significant. The results for the intervention subgroups showed that visuospatial ability improvement was significantly greater among those with a global cortical atrophy score of ≤15 (p < 0.05). CONCLUSION Human-computer interaction-based comprehensive training may improve cognitive functions among cognitively impaired elderly individuals. The training effect was most prominent among those with milder cerebral atrophy.
Regenerative Potential of Neonatal Porcine Hearts

Background: Rodent hearts can regenerate myocardium lost to apical resection or myocardial infarction for up to 7 days after birth, but whether a similar window for myocardial regeneration also exists in large mammals is unknown. Methods: Acute myocardial infarction (AMI) was surgically induced in neonatal pigs on postnatal days 1, 2, 3, 7, and 14 (ie, the P1, P2, P3, P7, and P14 groups, respectively). Cardiac systolic function was evaluated before AMI and at 30 days post-AMI via transthoracic echocardiography. Cardiomyocyte cell cycle activity was assessed via immunostaining for proliferation and mitosis markers, infarct size was evaluated histologically, and telomerase activity was measured by quantitative polymerase chain reaction. Results: Systolic function at day 30 post-AMI was largely restored in P1 animals and partially restored in P2 animals, but significantly impaired when AMI was induced on postnatal day 3 or later. Hearts of P1 animals showed little evidence of scar formation or wall thinning on day 30 after AMI, with increased measures of cell-cycle activity seen 6 days after AMI (ie, postnatal day 7) compared with postnatal day 7 in noninfarcted hearts. Conclusions: The neonatal porcine heart is capable of regeneration after AMI during the first 2 days of life. This phenomenon is associated with induction of cardiomyocyte proliferation and is lost when cardiomyocytes exit the cell cycle shortly after birth.
Early Evaluation of Circulating Tumor DNA as Marker of Therapeutic Efficacy in Metastatic Colorectal Cancer Patients (PLACOL Study)

Purpose: Markers of chemotherapy efficacy in metastatic colorectal cancer (mCRC) are essential for optimization of treatment strategies. We evaluated the applicability of early changes in circulating tumor DNA (ctDNA) as a marker of therapeutic efficacy. Experimental Design: This prospective study enrolled consecutive patients with mCRC receiving a first- or second-line chemotherapy. CtDNA was assessed in plasma collected before the first (C0), second (C1) and/or third (C2) chemotherapy cycle, using picodroplet-digital PCR assays based either on detection of gene mutation (KRAS, BRAF, TP53) or hypermethylation (WIF1, NPY). CT scans were centrally assessed using RECIST v1.1 criteria. Multivariate analyses were adjusted on age, gender, ECOG performance status (PS), metastatic synchronicity, and treatment line. Results: Eighty-two patients with mCRC treated in first- (82.9%) or second- (17.1%) line chemotherapy were included. Patients with a high (>10 ng/mL) versus low (≤0.1 ng/mL) ctDNA concentration at C0 had a shorter overall survival (OS; 6.8 vs. 33.4 months: adjusted HR, 5.64; 95% CI, 2.5–12.6; P < 0.0001). By analyzing the evolution of the ctDNA concentration between C0 and C2 or C1 (C2or1), we classified the patients in two groups (named “good” or “bad ctDNA responders”). In multivariate analysis, patients belonging to the group called “good ctDNA responder” (n = 58) versus “bad ctDNA responder” (n = 15) had a better objective response rate (P < 0.001), and a longer median progression-free survival (8.5 vs. 2.4 months: HR, 0.19; 95% CI, 0.09–0.40; P < 0.0001) and OS (27.1 vs. 11.2 months: HR, 0.25; 95% CI, 0.11–0.57; P < 0.001). Conclusions: This study suggests that early change in ctDNA concentration is a marker of therapeutic efficacy in patients with mCRC. Clin Cancer Res; 23(18); 5416–25. ©2017 AACR.
No increase in risk of hip fracture at high serum retinol concentrations in community-dwelling older Norwegians: the Norwegian Epidemiologic Osteoporosis Studies.

BACKGROUND Norway has the highest hip fracture rates worldwide and a relatively high vitamin A intake. Increased fracture risk at high intakes and serum concentrations of retinol (s-retinol) have been observed in epidemiologic studies. OBJECTIVE We aimed to study the association between s-retinol and hip fracture and whether high s-retinol may counteract a preventive effect of vitamin D. DESIGN We conducted the largest prospective analysis of serum retinol and hip fracture to date in 21,774 men and women aged 65-79 y (mean age: 72 y) who attended 4 community-based health studies during 1994-2001. Incident hip fractures occurring up to 10.7 y after baseline were retrieved from electronic hospital discharge registers. Retinol determined by high-pressure liquid chromatography with ultraviolet detection in stored serum was available in 1154 incident hip fracture cases with valid body mass index (BMI) data and in a subcohort defined as a sex-stratified random sample (n = 1418). Cox proportional hazards regression weighted according to the stratified case-cohort design was performed. RESULTS There was a modest increased risk of hip fracture in the lowest compared with the middle quintile of s-retinol (HR: 1.41; 95% CI: 1.09, 1.82) adjusted for sex and study center. The association was attenuated after adjustment for BMI and serum concentrations of α-tocopherol (HR: 1.16; 95% CI: 0.88, 1.51). We found no increased risk in the upper compared with the middle quintile. No significant interaction between serum concentrations of 25-hydroxyvitamin D and s-retinol on hip fracture was observed (P = 0.68). CONCLUSIONS We found no evidence of an adverse effect of high serum retinol on hip fracture or any interaction between retinol and 25-hydroxyvitamin D. If anything, there tended to be an increased risk at low retinol concentrations, which was attenuated after control for confounders. We propose that cod liver oil, a commonly used food supplement in Norway, should not be discouraged as a natural source of vitamin D for fracture prevention.
Teacher Professional Development in One K-12 School District in Rhode Island: A Study of Perceptions

The purpose of the qualitative phase of this study was to investigate teachers’ perceptions of professional development and the extent to which teachers believe it expands their knowledge and skills and improves student learning. Teachers from an urban ring district in Rhode Island were asked to participate in a focus group discussion. A thorough analysis of the content of the responses to focus group questions was completed. In general, teachers felt that the most effective professional development experiences had been on topics of their choice and those facilitated by teachers. According to focus group results, collaboration and relevancy were two additional characteristics of effective professional development. The results may assist districts, policy makers, and designers of professional development in the quest for more personalized professional learning.