Miracle-dz/UniFAR-FTUs huggingface dataset:
Gender And The Professional Predicament in Nursing

Introduction: The Discontents of Nurses. Part One Gendered Worlds: On gender, Identity and Action The Masculinity of Organizational Life. Part Two The Disorders of Nursing: Nursing Manpower: What's in a Name? Practice: The Polo-Mint Problem Educational Reform: Public Affirmation of the Worth of Nursing? Part Three Beyond the Parameters of Profession: Professionalism and the Conundrum of Care Managing to Care in the New NHS. Appendix: Gender and Nursing - A Brief Guide to the Literature.
Effect of housing in an enriched environment on the recovery from experimental inflammatory pain

Experimental pain research is often complicated by the absence of an objective and detailed method to analyze behavioral changes. In the present study acute pain was induced into the right knee of the rat (n = 15) through the injection of 2mg carrageenan (CAR) in saline. A control group received vehicle injection into the knee (n = 15). With the use of an automated quantitative gait analysis system, the CatWalk, it was possible to quantitatively analyze behavioral changes at post-injection time 2.5, 4, 24 and 48 hours. The CatWalk analysis of individual paw parameters like the intensity of the paw print or the time contact with the floor showed a significant effect after CAR injection into the knee. These CatWalk parameters were highly correlated with von Frey data and thus representative for the development of mechanical allodynia. Furthermore, detailed CatWalk analysis of the gait (i.e coordinated interaction between left and right hindlimb) showed very fine, accurate and significant coordination changes in the experimental rats as of 4 hours post-injection. In conclusion, the CatWalk method allows an objective and detailed detection of both pain induced gait adaptations as well as the development of mechanical allodynia in an acute inflammatory pain model.
Measuring the child mortality impact of official aid for fighting infectious diseases, 2000-2010

Aid for fighting infectious and parasitic diseases has had a statistically significant role in the under-five mortality reduction in the last decade. Point estimates indicate a country average reduction of 1.4 deaths per thousand under fives live-born attributable to aid at its average level in 2000-2010. The effect would be an average drop of 3.3 in the under-five mortality rate at the aid levels of 2010. By components, a dollar per capita spent in fighting malaria has caused the largest average impact, statistically higher than a dollar per capita spent in STD/HIV control. We do not find statistically significant effects of other infectious disease aid, including aid for the control of tuberculosis.
Determinants of infant mortality in Ethiopia: a study based on the 2005 EDHS data.

Abstract Background: According to the Ethiopian Demographic and Health Survey of 2000, the infant mortality rate in Ethiopia was estimated at 96.8 deaths per 1000 live births. Continuous follow up studies about infant mortality are vital to the development of the country. The present study is an undertaking against the background of the prevailing high rate of infant mortality based on Ethiopian Demographic and Health Survey data gathered in 2005. Objective: The main objective of this study was to determine socioeconomic, demographic and environmental factors/variables that could have impact on infant mortality in Ethiopia. Methods: The study used data from the 2005 Ethiopian Demographic and Health Survey. The Kaplan-Meier method and Cox proportional hazards regression model were employed to analyze the data. Results: The results of Kaplan-Meier estimation showed that most infant deaths occurred in the earlier months immediately after birth and then declined as the age of the infant advanced to 12 months. It was observed that about 47.9 % and 58.4% of the deaths, respectively, occurred in the first and second months of the follow up period. The Cox proportional hazards analysis identified “breast feeding status”, “mother’s age”, “mother’s level of education”, “child birth order”, “source of drinking water” and “sex of infant” as significant predictors of infant mortality. Conclusion: In order to reduce infant mortality, awareness creation efforts have to increase birth spacing, improve the level of education of mothers, encourage breastfeeding, provide access to safe water and discourage teenage pregnancy. To this effect, existing health policy guidelines related to birth have to be improved, and perhaps new ones be formulated, in order to achieve the desired outcome of reducing infant mortality. [Ethiop. J. Health Dev. 2012;26(2):72-77]
Recent trends in smoking prevalence in South Africa--some evidence from AMPS data.

Objective. To estimate trends in smoking prevalence among different demographic and income segments for the period 1993 - 2000. Methodology. Annual data were obtained from a commercially generated database focusing on product usage. Using regression techniques, trends in smoking prevalence were estimated. Results. Since 1993 aggregate cigarette consumption has decreased by 26%. Smoking prevalence has decreased from 32% to 27% of the adult population. This is ascribed mainly to the sharp increase in cigarette prices. Sixty per cent of the decrease in per capita cigarette consumption is explained by a reduction in average consumption of smokers. The other 40% is explained by a reduction in smoking prevalence. Smoking prevalence has been decreasing for most demographic and socio-economic groups. The most significant decreases have been recorded for males, blacks, young adults, and low-income households. Groups that have not experienced significant decreases in smoking prevalence include coloureds, whites, females, and high-income households. Conclusion. Rapidly increasing excise taxes are a powerful policy tool in reducing cigarette consumption. Because poor people spend a larger proportion of their income on cigarettes, their relative tax burden is higher than the more affluent sections of society. Cigarette excise taxes are therefore regressive. However, since the poor tend to reduce their consumption by a greater percentage than the rich in response to price increases, excise increases are likely to reduce the regressiveness of the tax. Nevertheless, in view of the low quitting rates, a strong case exists for the government to subsidise cessation and nicotine replacement therapies, especially among the poor. S Afr Med J 2002; 92: 468-472.
A novel hysteresis current controlled dual buck half bridge inverter

A high efficient and reliable topology-dual buck half bridge inverter is introduced. The existence of discontinuous conduction mode operation requires the bias of inductor current for DBI implemented with linear controllers like ramp comparison SPWM. A novel nonbiased current mode operation scheme for DBI and a hysteresis current controlled dual buck inverter (HCDBI) are proposed. The bias current required by RCSPWM DBI is eliminated and efficiency of the inverter is optimized. Comparison studies between conventional half bridge inverter (CHBI) and HCDBI based on losses computation and experiments are also executed. The results verify HCDBI's superior switching performance over CHBI. In addition, an inductor-coupled dual buck half bridge inverter is proposed and size of the filter inductors is reduced minimum.
Models of Adult Learning: A Literature Review

This paper summarises a broad review of literature on adult learning, describing the different models of adult learning and their significance for research and development in adult literacy, numeracy and English for speakers of other languages (ESOL). It examines models of adult learning to emerge from disciplines such as psychology and adult education. The aim is to provide useful ideas for developing teaching and learning within the Skills for Life strategy [indexed at TD/IRD 88.171]. The report concludes with a summary of the main findings of the review. Rather than viewing learning as an individual, cognitive phenomenon, it is suggested that a full understanding of adult learning must take into account the interrelationship of many factors in the learning situation, with the learner’s contexts, purposes and practices at the centre.
Methotrexate for topical application in an extemporaneous preparation

The antifolate agent methotrexate is routinely used for systemic therapy of cancer and chronic inflammatory diseases. Successful topical use has been described for individual therapeutic attempts, in case series, and small studies, especially for mycosis fungoides (premycotic stage) and lymphomatoid papulosis. With respect to its clinical use in selected treatment scenarios, there have been no approved preparations or regulated instructions for pharmaceutical compounding.
Immunomodulatory effects of novel therapies for stroke

During brain injury, microglia become activated and migrate to areas of degenerating neurons. These microglia, release pro-inflammatory cytokines and reactive oxygen species causing additional neuronal death. Microglia express high levels of sigma receptors, however, the function of these receptors in microglia and how they may affect the activation of these cells remain poorly understood. Using primary rat microglial cultures, it was found that sigma receptor activation suppresses the ability of microglia to rearrange their actin cytoskeleton, migrate, and release cytokines in response to the activators adenosine triphosphate (ATP), monocyte chemoattractant protein 1 (MCP-1), and lipopolysaccharide (LPS). Next, the role of sigma receptors was explored in the regulation of calcium signalling during microglial activation. Calcium fluorometry experiments in vitro show that stimulation of sigma receptors
Innovation, risk, and patient empowerment: the FDA-mandated withdrawal of 23andMe's Personal Genome Service.

On November 22, 2013, the US Food and Drug Administration (FDA) took the surprising step of ordering 23andMe, a genomics company, to cease marketing its flagship Personal Genome Service (PGS). The PGS is a DNA sequencing product marketed directly to consumers that claims to “help individuals and their doctors identify health areas that they need to keep an eye on. ” By determining the presence of certain single-nucleotide polymorphisms, the PGS estimates risk for more than 250 diseases and health conditions by extrapolating from research studies. After initially continuing to sell its product, 23andMe heeded the FDA’s warning letter and stopped offering health-related genetic tests on December 6, 2013.
Additional events in the RE-LY trial.

To the Editor: Boehringer Ingelheim recently conducted a targeted review of the 1387 deaths that occurred during the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial,1 which evaluated the effects of two doses of dabigatran, as compared with warfarin, on rates of stroke or systemic embolism and major bleeding. Also included in this review were the deaths of 6 patients who did not undergo randomization and 10 deaths that occurred after the end of the study. This review was conducted to determine whether a concurrent event may have occurred with respect to each death, even though such an event was .
Acute electrical isolation is a necessary but insufficient endpoint for achieving durable PV isolation: the importance of closing the visual gap.

AIMS Temporary, ablation-mediated effects such as oedema may cause reversible pulmonary vein (PV) isolation. To investigate this, point-by-point circumferential ablation was performed to achieve acute electrical PV isolation with an incomplete circumferential ablation line. Then, the impact of this intentional 'visual gap' (ViG) on the conduction properties of the ablation lesion set was assessed with adenosine and pacing manoeuvres. METHODS AND RESULTS Twenty-eight patients undergoing ablation for paroxysmal (n= 20) or persistent atrial fibrillation (n= 8) were included. Pulmonary vein (PV) ablation was performed around ipsilateral vein pairs. Once acute isolation was achieved, ablation was halted and the presence and size of the ViG were calculated. The ViG electrophysiological properties were tested with pace capture along the ViG at 10 mA/2 ms, and assessment for dormant PV conduction with adenosine. Despite electrical isolation, a ViG was present in 75% (n= 42/56) of vein pairs (21 of 28 left PVs and 21 of 28 right PVs). There was no difference in the ViG size between the left and right PVs (22.1 ± 14.2 and 17.3 ± 11.3 mm, P > 0.05). Dormant PV connections were revealed by adenosine in more than a quarter (n= 12/42) of acutely isolated PV pairs, of which the majority were dependent on conduction through the ViG. CONCLUSIONS Electrical PV isolation can usually be achieved without complete circumferential ablation. However, more than a quarter of these 'isolated' PVs exhibit dormant conduction-predominantly via the un-ablated 'ViGs' in the ablation lesion set. These findings support the hypothesis that reversible tissue injury contributes to PV isolation that may be acute but not necessarily durable.
Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial.

IMPORTANCE While effective in preventing stroke in patients with atrial fibrillation (AF), warfarin is limited by a narrow therapeutic profile, a need for lifelong coagulation monitoring, and multiple drug and diet interactions. OBJECTIVE To determine whether a local strategy of mechanical left atrial appendage (LAA) closure was noninferior to warfarin. DESIGN, SETTING, AND PARTICIPANTS PROTECT AF was a multicenter, randomized (2:1), unblinded, Bayesian-designed study conducted at 59 hospitals of 707 patients with nonvalvular AF and at least 1 additional stroke risk factor (CHADS2 score ≥1). Enrollment occurred between February 2005 and June 2008 and included 4-year follow-up through October 2012. Noninferiority required a posterior probability greater than 97.5% and superiority a probability of 95% or greater; the noninferiority margin was a rate ratio of 2.0 comparing event rates between treatment groups. INTERVENTIONS Left atrial appendage closure with the device (n = 463) or warfarin (n = 244; target international normalized ratio, 2-3). MAIN OUTCOMES AND MEASURES A composite efficacy end point including stroke, systemic embolism, and cardiovascular/unexplained death, analyzed by intention-to-treat. RESULTS At a mean (SD) follow-up of 3.8 (1.7) years (2621 patient-years), there were 39 events among 463 patients (8.4%) in the device group for a primary event rate of 2.3 events per 100 patient-years, compared with 34 events among 244 patients (13.9%) for a primary event rate of 3.8 events per 100 patient-years with warfarin (rate ratio, 0.60; 95% credible interval, 0.41-1.05), meeting prespecified criteria for both noninferiority (posterior probability, >99.9%) and superiority (posterior probability, 96.0%). Patients in the device group demonstrated lower rates of both cardiovascular mortality (1.0 events per 100 patient-years for the device group [17/463 patients, 3.7%] vs 2.4 events per 100 patient-years with warfarin [22/244 patients, 9.0%]; hazard ratio [HR], 0.40; 95% CI, 0.21-0.75; P = .005) and all-cause mortality (3.2 events per 100 patient-years for the device group [57/466 patients, 12.3%] vs 4.8 events per 100 patient-years with warfarin [44/244 patients, 18.0%]; HR, 0.66; 95% CI, 0.45-0.98; P = .04). CONCLUSIONS AND RELEVANCE After 3.8 years of follow-up among patients with nonvalvular AF at elevated risk for stroke, percutaneous LAA closure met criteria for both noninferiority and superiority, compared with warfarin, for preventing the combined outcome of stroke, systemic embolism, and cardiovascular death, as well as superiority for cardiovascular and all-cause mortality. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00129545.
Prognostic value of left atrial expansion index and exercise-induced change in atrial natriuretic peptide as long-term predictors of atrial fibrillation recurrence.

AIMS We propose to assess the value of exercise-induced change in N-terminal-pro atrial natriuretic peptide (NT-proANP) and left atrial expansion index (LAEI) in predicting AFR after cardioversion and their effect on AF-free survival. METHODS AND RESULTS Fifty-five patients with persistent AF of <18 months duration needing cardioversion were recruited for the study. Fifty-four patients were successfully cardioverted. At 3 months 28/54 (51%) were in SR and at 12 months 21/53 (39%). On multivariate analysis, only exercise-induced change in NT-proANP and LAEI were found to be predictive of AFR up to 12 months post-cardioversion and had an effect on AF-free survival. N-terminal-pro brain natriuretic peptide was elevated in all persistent AF patients but did not predict recurrent AF. CONCLUSIONS Left atrial expansion index and exercise-induced atrial natriuretic peptide change show promise as predictors of AFR after cardioversion. These predictors may identify patients at an early stage in their disease with intact neurohumoral feedback systems and less advanced atrial remodelling. Further studies are required to confirm these findings.
Vasovagal syncope: poorly understood, but well handled.

This editorial refers to ‘Cardiac autonomic disturbances in patients with vasovagal syndrome: comparison between iodine-123-metaiodobenzylguanidine myocardial scintigraphy and heart rate variability’ by G. Kochiadakis et al . , on page 1352 In this issue of the Journal, Kochiadakis and co-workers from Heraklion University Hospital in Athens report on autonomic regulation in patients with vasovagal syncope (VVS) diagnosed with tilt table testing.1 They measured heart rate variability (HRV) and assessed cardiac sympathetic innervation using 123-I-meta-iodobenzylguanidine (MIBG) scintigraphy. The main finding of this study was that adrenergic cardiac innervation showed defects in the left ventricle in patients with VVS. This finding was not associated with the type of response (cardioinhibitory or vasodepressor) during tilt table testing. However, the study critics may object that the infrequent blood pressure measurements rather than continuous non-invasive blood pressure measurement during tilt table testing did not allow the accurate classification of the response. In contrast to this finding, HRV, as a marker of the resulting efferent vasomotor activity at the level …
Resynchronization improves heart-arterial coupling reducing arterial load determinants.

BACKGROUND Cardiac resynchronization therapy (CRT) has benefits on left ventricle (LV) performance, but its mid-term effects on LV load and LV-arterial coupling are unknown. AIMS To evaluate CRT mid-term effects on LV-arterial coupling, arterial load and its determinants, and the association between CRT-dependent aortic haemodynamic changes and the arterial biomechanics. METHODS AND RESULTS Cardiac and aortic echographies were done in 25 patients (age: 61 ± 12 years; 14 men; New York Heart Association functional classes III-IV; LV ejection fraction = 28 ± 7%, QRS = 139 ± 20 ms) before and after (23 ± 12 days) CRT. Standard structural and functional parameters and dyssynchrony indices were evaluated. Ascending aorta flow and diameter waveforms were measured. Central pressure was derived using a transfer function and the diameter calibration method. Calculus: arterial elastance (EA); aortic impedance (Zc) and distensibility (AD); systemic resistances (SVR), total compliance (CT); global reflection coefficient; LV end-systolic elastance (EES); and LV-arterial coupling (EA/EES). After CRT EA diminished (-30%;P = 0.001), EES increased (29%; P = 0.001) and EA/EES improved (pre-CRT: 2.9 ± 0.9, post-CRT: 1.6 ± 0.7; P = 0.001). Arterial elastance changes were associated with changes in arterial properties. Cardiac resynchronization therapy was associated with pressure-independent increase in mean aortic diameter (pre-CRT: 30.0 ± 4.0 mm, post-CRT: 33.0 ± 5.1 mm; P = 0.005) and distensibility (pre-CRT: 3.8 ± 2.6 × 10(-3)mmHg(-1), post-CRT: 6.4 ± 2.5 × 10(-3) mmHg(-1); P = 0.002), and Zc reduction (pre-CRT: 3.5 ± 1.8 × 10(-2)mmHg.s/mL, post-CRT:1.9 ± 0.8 × 10(-2) mmHg.s/mL; P = 0.001) and SVR (pre-CRT:1.7 ± 0.4 mmHg.s/mL, post-CRT:1.0 ± 0.3 mmHg.s/mL; P = 0.001). Changes in EA determinants were associated with changes in aortic flow. CONCLUSION Early after CRT central and peripheral arterial biomechanics improved, determining a pressure-independent increase in aortic diameter and a reduction in arterial load. Left ventricular systolic performance and LV-arterial coupling were enhanced. Arterial biomechanical changes were associated with aortic flow changes.
Do Higienismo às ações promotoras de saúde: a trajetória em saúde vocal

This paper has the objective of discussing the use of the terms “vocal hygiene” and “vocal health” by considering that the option for this or that term implies changes in references and conceptions that determine different proposals for educational health actions, in special in Speech and Language Pathology. This study is based on social and historical aspects of “Hygienism” in Public/Collective Health and Health Education in Brazil. It seeks to understand the specificities and implications of praxis in Speech and Language Pathology. It offers reflection about the hygienist character of educational practices in health and shows that traditionally, the practices under the denominations “vocal hygiene” and sometimes, “vocal health” have been structured on hygienist fundamentals, that goes against the proposals of Health Promotion. This article contributes to think about health education in several health areas; indicates the need to redirect the Speech-Language-Pathology practices in Public Heath and to search for a terminology, in special in voice area, that demonstrates coherence with the development of educational processes based on the proposals of Health Promotion.
MRS in MS, With and Without Interferon Beta 1a Treatment, to Define the Dynamic Changes of Metabolites in the Brain, and to Monitor Disease Progression

Multiple sclerosis (MS) is a common cause of chronic neurological disability in young adults. Magnetic Resonance Imaging (MRI) readily identifies multifocal white matter lesions(WML) that represent areas of demyelination and is thus useful in supporting the diagnosis of MS, even after a single clinical episode(McDonald et al., 2001). MRI is also widely used to monitor disease progression in natural history and in therapeutic trial studies. However, conventional MRI does not detect the subtle histopathological changes that are described in the normal-appearing white matter (NAWM) in patients with MS(Allen & McKeown, 1979; Bitsch et al., 1999). MRS has been used in the evaluation of MS to help further define the nature of the lesions revealed by T2-weighted MRI(Arnold, Matthews, Francis, O'Connor, & Antel, 1992; Arnold et al., 1994; Bitsch et al., 1999; Davie et al., 1997; De Stefano et al., 1995; Fu et al., 1998; Gonen et al., 2000; Matthews et al., 1996; Narayana, Doyle, Lai, & Wolinsky, 1998; Pan et al., 1996; Rooney et al., 1997; Sarchielli et al., 1999; Tourbah et al., 1999; van Walderveen, Barkhof et al., 1999). The measurement of N-acetly aspartic acid (NAA) is thought to be a marker of axonal loss, damage or dysfunction. Many studies (Arnold et al., 1992; Arnold et al., 1994; Davie et al., 1997; De Stefano et al., 1995; Husted et al., 1994; Narayana et al., 1998,( Allen & McKeown, 1979; De Stefano et al., 1995; Fu et al., 1998; Husted et al., 1994; Narayana et al., 1998) have shown a reduction in the absolute concentration of NAA or the NAA/Cr ratio in MS lesions. However, pathological(Allen & McKeown, 1979) and quantitative MRSI studies(Armspach, Gounot, Rumbach, & Chambron, 1991; Filippi et al., 1995; Gasperini et al., 1996; Loevner et al., 1995) have shown that in patients with clinically definite MS, abnormalities also occur in the NAWM(Arnold et al., 1992; Davie et al., 1997; Davie et al.,