Miracle-dz/UniFAR-FTUs huggingface dataset:
Neural Regenerative Options in the Management of Ischemic Brain Injury

Neural Regenerative Options in the Management of Ischemic Brain Injury U recently, it was widely believed that neuronal production in the mammalian brain occurred only during the prenatal period. Over the past 15 years, however, evidence has shown that neurogenesis continues in certain areas of the adult mammalian brain, namely, in the subventricular zone and hippocampal dentate gyrus (Fig. 1). An obvious question is whether adult neurogenesis has the potential to replace dying neurons in the setting of brain injury. New evidence indicates that such neurogenesis is indeed possible. The logical clinical implication of this finding is the potential to augment the production of mature neurons in the injured brain. This ability would be of considerable value in victims of large strokes who seldom regain significant function in distributions where neural tissue has died. In contrast to the recently discovered adult neurogenesis, hematopoietic stem cells have been studied extensively for a relatively long time. The hematopoietic system contains a pool of progenitor cells that differentiate into mature cells. Studying the molecular mechanisms governing the proliferation, differentiation, and apoptosis of the hematopoietic stem cell population provides valuable clues about the biology of neural progenitor cells. This review examines neurogenesis in the normal brain and in response to ischemic insults. Factors that drive proliferation of stem cell populations into neural progenitor cells and those that drive differentiation of neural progenitor cells into neurons and, ultimately, integration into neural networks are discussed. Such therapeutic modalities can be broadly classified as using either an exogenous or an endogenous approach. These basic isIschemic brain injury is a difficult clinical scenario for which adequate treatment paradigms are lacking. The formation of ischemic scar tissue in the cerebral cortex creates a barrier to regenerative efforts and restoration of function. Various agents that regulate the cell cycle hold promise for modulating the naturally progressive formation of this astrocytic scar tissue. Use of these agents will involve the development of strategies that influence the regenerative potential of neural progenitor cells.
The Long-run Gradient in Health by Education: Obesity and Overweight

The growing body of population in the U.S. has suered from obesity with an increasing rate. As of 2010, more than one third of adults in the US (35.7%) are obese. The obesity entails many health problems but the concern is there are signi…cant disparities in overweight status by education level. The more individuals are educated the less likely they are obese. In this study I inves- tigate the causal eect of education on Body Mass Index (BMI), the primary measure of obesity and overweight, using sibling data from the US. From the cross-sectional analysis I …nd a negative relationship between education and BMI. When observed and unobserved family …xed eects shared by siblings are accounted for, the negative eect of schooling on BMI is reduced substantially but remains statistically signi…cant. It is found that one year of schooling is associated with about 0.4 percent decrease of BMI. Consistent with BMI re- sults, the obesity and overweight status are also signi…cantly associated with schooling. The signi…cant eects of education on BMI, overweight and obesity status are robust in various speci…cations.
A stitch in time saves lives. A community intervention in The Gambia

Malaria is a major cause of infant and child mortality in Africa. Bednets are currently the best means of protection, especially those treated with insecticide. However, untreated bednets offer no protection if they have five or more finger-sized holes, are not long enough to be tucked in under the mattress or are badly torn. Despite the long tradition of using bednets in The Gambia, around 42% of nets in rural Gambia are in poor condition or used incorrectly (Clarke et al, 2001). This six month study (July to December 2002) set out to examine whether villagers could be encouraged to change their behaviour and repair holes in and use their bednets correctly through an intervention developed through community participation. Through focus group discussions and interviews, culturally compelling interventions developed were health education songs composed and sung by the villagers with complementary posters displayed in the two study villages. The songs were recorded on cassette tapes and were sung at formal and informal village gatherings. The success of this intervention was quantified by bednet surveys, where the condition of 554 nets was recorded before and after the intervention. To measure the impact of people’s behaviour, mosquitoes were collected from under bednets, pre and post intervention, and general mosquito levels were monitored throughout the study using light traps. Data analysis showed a significant increase in the proportion of repairs post intervention compared to pre-intervention (paired T-Test, P=<;0.001). However, the overall number of holes remained the same due to constant wear and tear of the bednets and so there was not a significant reduction in exposure to mosquitoes. Nevertheless, these results show encouraging signs of enabling a behaviour change towards improving existing bednets using participatory methods.
(Z)-4-(Carbomethoxymethylene)-2-(4-fluorophenyl)-4H-benzo[d][1,3]oxazine

The title compound, (Z)-4-(carbomethoxymethylene)-2-(4-fluorophenyl)-4H-benzo[d][1,3]oxazine, was synthesized in 68% isolated yield by palladium-catalyzed oxidative cyclization-methoxycarbonylation of 4-fluoro-N-(2-((trimethylsilyl)ethynyl)phenyl)benzamide. This new heterocyclic derivative was fully characterized by IR, 1H-NMR, 13C-NMR spectroscopies, MS spectrometry, and elemental analysis. The Z configuration around the double bond was unequivocally established by 2D NOESY experiments.
Chronic Pain Management in Managed Care Organizations: A National Survey of Medical Directors

A national mailed survey of medical directors was conducted to determine the extent to which managed care organizations (MCOs) are managing chronic pain. The overall survey response rate was 25.5%. Of the responding MCOs, 32% had a formalized mechanism for identifying members with chronic pain and 18% systematically used clinical practice guide- lines for pain management. Many more MCOs had formulary controls in place to manage pain medications. Among the most commonly used controls cited were (1) controlling number of units per month (57%), (2) having tiered co-pays (56%), and (3) requiring prior authorization for specific agents (54%). The most important considerations cited in mak- ing formulary determinations included (1) efficacy, when com- pared with other leading analgesics (88%), (2) the side-effect profile and tolerability (82%), (3) improvement in the patient's functional ability (76%), (4) warnings and contraindications (75%), and (5) cost (74%). Of the MCOs that did not have a pain- management program, most (78%) considered pain in patients to be a low priority; however, 59% of all respondents expressed concern about the impact of pain medications on the pharmacy budget. The findings suggest that additional effort must go into under- standing the impact of pain on medical utilization, productivity, and quality of life, in addition to developing programs that increase MCOs' attention to pain management as a care- delivery priority.
A report of five cases of fluoroquinolone-induced epidermal necrolysis at a tertiary care teaching hospital in Northern Karnataka

Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening, epidermal necrolytic adverse drug reactions (ADRs) considered to be within a spectrum of severe exanthematous vesico-bullous disorders, mostly attributable to drugs like anticonvulsants, NSAIDS and antimicrobials. Lately, the reports on Fluoroquinolone (FQ) induced SJS/TEN are rising. Our retrospective study conducted in this direction, brings in five such cases which manifested with severe epidermolyticmucocutaneous lesions after taking oral FQ therapy for gastrointestinal/ respiratory/genito-urinary indications. With the dechallenge of offending agents and adequate management of patients‟ clinical condition, four of them improved but the immunocompromised patient with TEN died despite intensive systemic corticosteroid and I.V-immunoglobulin therapy.
ANALYSIS OF SERUM OXIDANT - ANTIOXIDANT STATUS IN PATIENTS WITH IRON DEFICIENCY ANEMIA (IDA)

Iron deficiency is the most common deficiency worldwide, with negative effects on work capacity and on motor and mental development of infants, children, and adolescents, particularly in developing countries. Free radicals were generated due to the oxidative damage to the red blood cells and the exact pro-oxidant & antioxidant status in iron deficiency anemia was still ambiguous. Hence we have conducted this study not only to analyse but also to gain new insights into the oxidant-antioxidant status in patients diagnosed with iron deficiency anemia. This study was conducted in Saveetha Medical College & Hospital, Saveetha University with twenty patients diagnosed with iron deficiency anemia as study subjects and twenty age & sex matched healthy individuals as controls. Hemoglobin, ferritin, malondialdehyde, glutathione levels and the activity of the glutathione-s-transferase were measured in study subjects and compared to controls. There was a significant increase in malondialdehyde levels confirming the existence of oxidative stress in patients with iron deficiency anemia, compared to controls. The non-enzymatic and enzymatic antioxidants viz. glutathione and glutathione-s-transferase were beneficial in combating with the oxidative stress and this was evident with the decreased levels of the same in these patients compared to controls. The results of our study emphasize the use of antioxidants as a secondary therapy to reduce the oxidative damage in patients with iron deficiency anemia.
British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009

1. It is not necessary to perform a chest radiograph in patients with suspected CAP unless: – The diagnosis is in doubt and a chest radiograph will help in a differential diagnosis and management of the acute illness. [D] – Progress following treatment for suspected CAP is not satisfactory at review. [D] – The patient is considered at risk of underlying lung pathology such as lung cancer. [D]
Funcionalidad y salud: una tipología del envejecimiento en México

Objective. To analyze present conditions of aging in Mexico within the scope of health status and risk factors. Materials and Methods. Four types of aging are depicted: ideal, active, habitual and pathological. Indicators include chronic diseases, cognitive impairments, functional capacity, health self-assessment, consumption of alcohol and tobacco and physical activity. Data come from the survey of the popula tion 50 years and older in the 2001 Mexican Health and Aging Study (MHAS). Results. Findings corroborate the relations between aging and each one of the variables studied, but even more importantly, they indicate a typology that combines all variables in a single index. Conclusions. The typology that resulted from this study provides guidelines for delimiting the factors that lead to aging under good conditions and, therefore, suggests interventions and plans for good health and wellbeing, although it also indicates that pathological aging can occur at an early age. In addition, new research topics arose.
A Suitable Model for Breaking Bad News: Review of Recommendations

Most physicians experience difficulty when required to deliver bad news. Therefore, recommendations for facilitating breaking bad news were reviewed and a suitable model was described in this study. We performed a search with keywords “breaking bad news”, “strategy”, “protocol”, “guideline” and “model” as the primary descriptors, and limiting the sources to English language articles with abstracts and guidelines, published since 1961 to March 2013. Two trained authors independently reviewed titles, abstracts and full texts of articles after a pilot inter-rater reliability assessment. All articles dealing specifically with breaking bad news were examined; they were descriptive and analytical studies. Recommendations and best models for facilitating breaking bad news from these articles were explored; sorted into discrete categories, summarized and framed as the best model for breaking bad news. The latest models, tools, steps and recommendations (e.g., delivering the bad news at a suitable and calm environment, giving the news with empathy and …) were examined. Although many articles have discussed the topic of breaking bad news, those that occurred repeatedly throughout these articles were summarized. Finally, the reference steps as according to the most important models for breaking bad news were presented. It is suggested that for more effective investigations, studies regarding interactional approaches in patients–medical team relationships be conducted on breaking bad news interventions.
Treatment of Lumbar Degenerative Disc Disease Using a Novel, Compressible Core Prosthesis: 24-Month Results

Abstract Background: Low back pain is one of the most prevalent problems in industrialized countries and often results in decline in the quality of life of the affected individuals. There are a number of contributors to low back pain, one of which is Degenerative Disc Disease (DDD) of the spine. Although fusion has been well accepted for the treatment of DDD, high rates of complications and stress to adjacent segments remain a concern. Iumbar Total Disc Replacement (lTDR) is one technology that has become popular as an alternative to fusion. Artificial disc replacements were developed with a goal of preserving motion and avoiding various fusion-related complications. Methods: This is a multi-center, single arm, prospective post-market registry of the M6®-L, a compressible core TDR, consisting of consecutive patients presenting with lumbar DDD who agreed to participate. Clinical outcome measures include the Oswestry Disability Index (ODI) and back and leg Visual Analogue Scales (VAS). Data was collected pre-operatively, peri-operatively and post-operatively at 6 weeks, 3, 6 and 12 months and yearly thereafter. AP, Lateral and flexion/extension x-rays were performed for radiographic analysis. Patients are monitored continuously to track complications. Results: Results for 45 patients, (20 males, 25 females, mean age 44.6 years) are reported. Thirty-one patients were treated at 1 level, and 14 at multiple levels, between L3 and S1. Mean ODI has decreased significantly (p<0.001) from 45.9 ± 16.5% at baseline to 19.7 ± 19.3 at 2 years post-implant. Low back pain has also decreased significantly (p<0.001) from baseline with a preoperative back pain VAS of 7.0 and a 2 year value of 2.5. Physiologic range of motion was maintained from baseline through 2 years. Conclusions: Two year results from the post-market registry suggest initial device safety and effectiveness when used for the treatment of lumbar degenerative disc disease.
Phase II trial of nab-paclitaxel (nanoparticle albumin-bound paclitaxel (ABX)) + capecitabine (XEL) in first-line treatment of metastatic breast cancer (MBC)

1053 Background: ABX and XEL both have substantial single agent activity in MBC. Taxane and anti-metabolite doublets improve response rate and TTP and longer survival. ABX administered weekly has an excellent safety and efficacy profile with maintenance of dose intensity. This study was designed to test the safety and efficacy of ABX + XEL given in a novel combination schedule. Methods: This phase II, multicenter open label study utilized ABX 125 mg/m2 IV on day 1, 8 and with no premeds and capecitabine 825 mg/m2 PO BID days 1–14 on a Q 3 week cycle. The primary endpoint is objective response rate, with evaluation performed after every 2 cycles. Entry criteria include measurable MBC by RECIST criteria, age >18, PS 0–2, no prior chemo for metastatic disease, > 6 months since adjuvant fluoropyrimidine and/or paclitaxel. Results: The full sample of 50 patients (pts) have been enrolled; data from 43 pts are available for analysis. Median age is 58 (range 23.7–90.6). 37% received prior adjuvant anthracycline a.
Effect of an experiential learning model for simulation design on clinical nursing judgment development in pre-licensure baccalaureate nursing students

Error! Bookmark not defined. Dedication . vi Acknowledgements . vii List of Tables . xi List of Figures . xii Chapter 1: Introduction . 1 Background . 1 Purpose . 5 Research Questions . 6 Definition of Terms . 7 Assumptions . 12 Limitations . 14 Significance to Nursing . 16 Summary . 17 Chapter 2: Review of the Literature . 18 History of Simulation and Current State of the Science . 18 Experiential Learning Theory . 24 Summary . 43 Chapter 3: Methods . 45 Research Design . 45 Research Questions . 47 Participants . 48
Perception and Use of Communication Care Plans by Certified Nursing Assistants in Nursing Homes: The Role of Professional Support

OF DISSERTATION PERCEPTION AND USE OF COMMUNICATION CARE PLANS BY CERTIFIED NURSING ASSISTANTS IN NURSING HOMES: THE ROLE OF PROFESSIONAL SUPPORT The majority of individuals in nursing homes have cognitive-communication impairments which impact quality of care because direct care providers, certified nursing assistants, (CNAs) are unsure how to respond to resident’s communication behaviors. One intervention that facilitates staff-resident communication in nursing homes is communication plans; however, the research to date about communication plans has not specifically involved CNAs. The purpose of this study, using a grounded theory qualitative approach, was to describe development, implementation and evaluation of communication care plans (CCPs) for residents with cognitive-communication impairments in nursing homes by CNAs who did and did not receive professional support. Communication care plans are communication plans with the addition of autobiographical information. Twenty residents and ten CNAs from two nursing homes participated in the study. Once CCPs were created, CNA participants in one facility received support each day. Following two weeks, CNAs participated in a semi-structured interview. Interviews were transcribed and analyzed using open, axial and selective coding. Findings revealed a core category, meeting resident’s needs through professional support and communication, which describes the progressive process these CNAs underwent to effectively communicate with residents in nursing homes using CCPs. Evolution of this process occurred as CNA participants became familiar with residents. An underlying component facilitating this familiarity was support during CCP implementation. Initially, these CNAs had negative views about nursing home care because they were unsure how to communicate with residents and received little support from higher levels of nursing authority. Over time and with application of CCPs, CNAs became familiar with residents and their communication behaviors. Application of specific communication strategies on CCPs required ongoing support from the investigator/speech-language pathologist which was evident by the comments between CNA participants from each facility. Participants from both facilities reported positive experiences during application of the autobiographical information on the CCPs. This personal information coupled with increased knowledge about resident’s specific communication abilities fostered the formation of a relationship between residents and CNAs. In summary, support during application of CCPs supplements CNAs’ abilities to meet residents’ needs.
Quality assessment and stability study of compounded furosemide syrup

Compounded oral preparations, made with use of manufactured products as sources of active pharmaceutical ingredients, are characterized by short beyond-use-dates due to their instability. Aim: The aim of this study is to investigate the physical, chemical and microbiological stability of compounded furosemide syrups within a 30 days period. Methods: Batches of 5 mg/ml compounded syrups, using furosemide substance and commercial tablets (two brands) as sources of active pharmaceutical ingredients, were stored in the dark at 5±3 °C and 23±2 °C and examined at days 0, 7, 15, 23, and 30 for changes in physical (pH, formation of colour, gas, odour and changes in viscosity), chemical and microbial stability. A stress test was conducted in order to distinguish signs of chemical instability using a stability-indicating thin-layer chromatographic method. Bacterial inoculation of these samples were examined for microbial stability based on the total aerobic microbial count (TAMC <100), the total combined yeasts/moulds count (TYMC <10) and absence of Escherichia coli. Results: Throughout the storage period the investigated syrups showed no extra spots on the chromatogram, no significant changes in pH, colour, odour, gas formation, viscosity. On day 30, the content (≥99.3%) of furosemide, total aerobic microbial count (< 10 2 ), total combined yeasts/moulds count (<10 1 ) in studied samples were within acceptable limits. Stressed samples showed presence of extra and diminished spots. Conclusions: Extemporaneous syrups of furosemide substance and dispersed furosemide tablets, stored in glass bottles in the dark at 5±3 °C and 23±2 °C, was found to be physically, chemically and microbiologically stable for at least 30 days
Anaesthesia for Caesarean Section in a Patient with Spinal Muscular Atrophy

This report describes a 33-year-old primigravid woman with spinal muscular atrophy Type III (Kugelberg-Welander syndrome). Elective caesarean section was performed at 38 weeks gestation under spinal anaesthesia. The implications of spinal muscular atrophy for anaesthesia for caesarean section are described.
The antinociceptive effect of hydro-alcoholic extract of leave Mentha pulegium in formalin test in male rat

Background and aim: Drug researchers believe that pain relief medicines, because of their side effects and in some cases because of their inabilities are not useful. Therefore, it is necessary to do more research to find out new antinociceptive drugs. In the present study, antinociceptive effect of hydro-alcoholic extract of Mentha pulegium leave has been evaluated in male rats. Methods: In this experimental study, 40 adult male wistar rats, in the weight range of 220- 230 g were used. Antinociceptive response was evaluated by formalin test in five groups of 8 animals. Three experimental groups received 3 different doses of hydro alcoholic extract from the leaves of Mentha pulegium (400, 800, 1600 mg/kg, respectively). Sham group received distilled water and formalin only and the control group received no drugs. The extracts were injected intraperitoneally (i.p.), 15 minutes before the formalin test. Minutes 0-5 and 15-60 were designated as the acute and chronic phase of pain, respectively. After recording behavioral responses, the average pain scores in experimental groups and control group were statistically evaluated using t-test and Tukey’s test. Results: A significant difference was seen in mean pain scores between 3 experimental groups in the acute stage of formalin test. In the chronic stage, the only significant difference was seen between the experimental group which had been received 1600 mg/kg Mentha pulegium and two other groups (sham and control group) (P<0.05). Conclusion: According to the results of this research, the hydro-alcoholic extract of the leaves of Mentha pulegium reduces the pain in the acute stage more than chronic stage. However, more research is needed to find out the effective antinociceptive compounds in Mentha pulegium.