Miracle-dz/UniFAR-FTUs huggingface dataset:
Integrated Health Care – a population health approach in South Western Sydney

Introduction: Wollondilly Shire is a heterogeneous rural community (population 45,000) in the South Western Sydney growth corridor. The Wollondilly Health Alliance (WHA), a partnership between South Western Sydney Local Health District (SWSLHD), South Western Sydney Medicare Local (SWSML) and Wollondilly Shire Council (WSC), was established in 2013 to address increasing needs for health services in the region. In addition, the WHA includes local primary care providers, Non Government Organisations (NGOs), local community groups and business representatives. The aims are to develop, implement and evaluate models of integrated care that enable enhanced connectivity between providers of primary and secondary care, embed a population health approach to preventative health care and self-management with the long term aim of more efficient use of health services, appropriate use of emergency departments and avoid unnecessary admissions. This paper describes the methodology and evaluation framework adopted for this project, and the progress to date. Methodology: The 3 partners in the WHA agreed to share equally in the costs of the initial planning phases of a health plan based on integrated care principles. The planning phase includes a comprehensive needs assessment, survey of local residents, desk top analysis of local health data including data extracted from local general practices, and extensive face to face consultations with over 100 local health services providers and staff of NGOs, government, and community organisations. The needs assessment information collected and analysed will guide a strategy and priority setting workshop with representation from the local health care providers and community. The workshop will address what integrated health will look like in Wollondilly, what strategies need to be employed, who will be responsible and the resources required. The evaluation framework will be both formative and summative, describing the context, structures and mechanisms established to implement and evaluate the model(s) of care established by the needs assessment and workshop, indicators of access to and impact on the actors in the delivery and use of primary and secondary care services, and patient outcomes. Outcomes to date/Discussion: The data collected so far by the Comprehensive Needs Assessment identified 17 local priorities (broken into 3 categories of population cohort issue, World Congress on Integrated Care 2014, Sydney, November 23-26, 2014. International Journal of Integrated Care – Volume 14, 8 December – URN:NBN:NL:UI:10-1-116683– http://www.ijic.org/ health issue and system issue) that need to be addressed to move towards an integrated care system. These priorities arose from more than 500 surveys completed by local residents, contributions received from over 35 different providers, and representatives from the 3 levels of government in this region. The priorities set in the workshop will be addressed in the presentation. Author: SWS Integrated Health Committee 5 August 2014
Economic Analysis, Egg Quality Characteristics and Growth Parameters of Pullets Fed Graded Levels of Recycled Vegetable Wastes

A feeding trial was conducted to evaluate the economic analysis, egg quality characteristics and growth parameters of pullets fed graded levels of recycled vegetable wastes. Sixty (60) Shika Brown pullets of 22 week old were used for the experiment. The sixty pullets were selected from a pool of eighty (80) pullets and were randomly assigned to five (5) treatments with twelve (12) birds per treatment in a Completely Randomized Design (CRD) on the basis of vigor. Each treatment group was further replicated 4 times with three (3) birds per replicate and housed in 2m x 3m pen on a deep litter and fed water and feed ad libitum starting from 7.00 am daily for the twentyone (21) days of the feeding trial. Five experimental diets were prepared to contain 1.0, 1.5, 2.0 and 2.5% of the homogenized vegetable meal (HVM), for treatment 1, 2, 3, 4 and 5, respectively. Treatment 1 served as control. The percentage hen-day egg production, albumen index, average feed intake, shell thickness, and yolk color index for all treatments were not significant (p>0.05). Average weight (g), Haugh unit, Yolk index and Feed conversion ratio (FCR) shows that treatments 4 and 5 were significantly better (p<0.05) than in treatments 1 to 3. Birds on treatments 4 and 5 converted feed most effectively into an egg (p<0.05). Feed cost/kg bag for treatments 3, 4 and 5 were significant (p<0.05) and more economical than treatments 1 and 2. Feed used (kg) to produce the kg of egg were significantly better (p<0.05) in treatments 4 and 5 than the rest of the treatments, with the control diet numerically poorer (2.00kg fee/kg egg produced). The cost of feed/kg egg decreased with an increase in the inclusion rate. Treatments 2, 3, 4 and 5 were significantly less expensive (p<0.05) than treatment 1.
Proboscis lateralis- A 17 years follow-up, a case report

Proboscis lateralis is a rare congenital anomaly for which no embryological basis has been established. Besides heminasal aplasia or hypoplasia, various other craniofacial anomalies are also associated with it. It is only uncommonly free of other anomalies. Evaluation of a patient should include CT scan examination to look for growth of facial and skull bones. Reconstruction should start at an early age. Proboscis itself is the best option for heminose formation. Cartilaginous or bony support can be planned later in the late teens to give good aesthetic result.
PENERAPAN MODEL PEMBELAJARAN KOOPERATIF TWO STAY TWO STRAY UNTUK MENINGKATKAN AKTIVITAS DAN HASIL BELAJAR IPA SISWA SEKOLAH DASAR

Masalah dalam penelitian ini adalah rendahnya aktivitas dan hasil belajar IPA sebesar 58,3% atau 14 siswa dari 24 siswa yang mencapai tingkat ketuntasan. Tujuan penelitian adalah untuk meningkatkan aktivitas dan hasil belajar IPA dengan menerapkan model Kooperatif Two Stay Two Stray. Jenis penelitian yang digunakan adalah Penelitian Tindakan Kelas (PTK) yang terdiri dari empat tahapan dalam setiap siklusnya yaitu perencanaan, pelaksanaan, pengamatan, dan refleksi. Penelitian dilaksanakan sebanyak dua siklus yang setiap siklusnya terdiri dari dua pertemuan. Alat pengumpul data penelitian adalah lembar observasi dan soal tes. Teknik analisis data menggunakan teknik analisis kualitatif dan kuantitatif. Hasil penelitian pada siklus I rata-rata komponen aktivitas siswa secara klasikal sebesar 8,8 dengan persentase siswa aktif 73% (kategori cukup), siklus II komponen aktivitas klasikal meningkat sebesar 1,7 sehingga menjadi 10,5 dengan persentase siswa aktif meningkat sebesar 14,5% sehingga menjadi 87,5% (kategori aktif). Adapun rata-rata hasil belajar kognitif siswa pada siklus I sebesar 75,3 (kriteria baik) dan meningkat sebesar 10,5 sehingga siklus II menjadi 85,8 (kriteria baik). Dengan demikian, pembelajaran IPA dengan menerapkan model Kooperatif Two Stay Two Stray dapat meningkatkan aktivitas dan hasil belajar IPA siswa.
Infrared fluorescence measurements – The influence of calibration frequency on longitudinal in vitro measurements with KaVo DIAGNOdentTM

With today's widespread use of fluoride, the nature of cavities has changed. Harder, and therefore more resistant enamel can many times conceal subsurface decay and the caries disease progresses, in many cases, for a prolonged period with low activity and slow progression. The change in pattern of the caries disease calls for a shift in treatment philosophy; the original maxim of ‘extension for prevention’ has been eschewed for a minimal intervention approach, although this approach is only effective if caries is diagnosed at an early stage. Incorrect diagnosis results in incorrect treatment decisions. In the current age of lower overall prevalence of decay and slow disease progression, the potential risk of unnecessary restorations is greater than the risk of missing early decay. As an adjunct to conventional caries diagnostic methods such as visual inspection and bitewing radiography, a need for objective quantitative detection methods is of high importance. KaVo DIAGNOdentTM (KaVo Dental, Biberach, Germany) is a laser fluorescence device developed for caries detection and quantification as an adjunct to visual inspection and radiographic examination. The aim of this in vitro study was to investigate the stability of the instrument for longitudinal measurements. The study was carried out in two subsequent parts where measurements were performed in two series, with and without calibration. The material in Part I of the study comprised 30 extracted teeth with various stages of carious lesions measured with one DIAGNOdentTM device. In Part II, two devices were used to determine their unanimity and measurements were performed on six fluorescence standards in order to minimize false positive readings. The first series in Part I, with only one initial calibration, showed a significant change over time: a linear trend with drifting towards lower readings (P < 0.001). In the second series, with frequent calibrations, no significant linear trend over time could be demonstrated (P = 0.09). Clinically relevant differences in mean value between the series of measurements were seen over time (without frequent calibration, 7.64; with frequent calibration 8.57). The mean value of readings from the series with frequent calibrations was approximately 1 unit higher throughout the study, and single observations were 1–6 units higher. Results from Part II showed a significant systematic over-time difference between the factor ‘without’ and ‘with’ calibration (P = 0.0023) independent of which device that was used (P = 0.67). There was no significant difference between the devices, DDI and DDII (P = 0.14). The interaction, time × calibration, was significant (P < 0.000) with stable readings over time in the period ‘with calibration’, while the readings in the period ‘without calibration’ was drifting towards lower readings from day 1 and forward. From this in vitro study it was concluded that frequent calibration of DIAGNOdentTM should be performed in order to obtain comparable data for longitudinal monitoring.
VARDİYALI ÇALIŞMA SİSTEMİNİN ÇALIŞANLARIN İŞTEN AYRILMA NİYETİNE ETKİSİ ÜZERİNDE İŞ YAŞAM DENGESİNİN ARACILIK ROLÜ

Bu calisma, havacilik sektorunde vardiyali calisma duzeninin calisanlarin isten ayrilma niyeti uzerindeki etkisini ve bu nedensellik iliskisinde is yasam dengesinin aracilik rolunu tespit etmek icin gerceklestirilmistir. Bu amaca yonelik olarak, literatur taramasi sonrasinda, Antalya Havalimani’nda toplam 517 calisani olan bir yer hizmetleri sirketinde 256 calisan uzerinde anket teknigine dayali bir arastirma gerceklestirilmistir. Anketlerden elde edilen veriler, SPSS 22 istatistik yazilimi ve PROCESS makrosu kullanilarak analiz edilmistir. Arastirmadan elde edilen bulgulara gore, vardiyali calisma sisteminin isten ayrilma niyeti uzerindeki etkisinin istatistiksel olarak anlamli oldugu tespit edilmistir (β= .49; p 0.05). Bu aracilik iliskisi, Sobel (1982) testiyle incelendiginde is yasam dengesinin, vardiyali calisma sistemi ile isten ayrilma niyeti arasindaki iliski uzerindeki aracilik etkisinin istatistiksel olarak anlamli oldugu saptanmistir (z= 5,29, p<0.01).
LOSS OF MULTIDRUG RESISTANCE-ASSOCIATED PROTEIN 1 (MRP1/ABCC1) POTENTIATES DOXORUBICIN-INDUCED CARDIOTOXICITY IN MICE

OF DISSERTATION LOSS OF MRP1 POTENTIATES DOXORUBICIN-INDUCED CARDIOTOXICITY IN MICE Doxorubicin (DOX) is a broad-spectrum and effective chemotherapeutic agent, but its use in oncologic practice is limited by dose-dependent cumulative cardiotoxicity. DOX-induced cardiotoxicity is in large part due to its ability to cause oxidative stress. Multidrug resistance associated protein 1 (MRP1/ABCC1) is a member of the ATP-binding cassette (ABC) transporter superfamily. By effluxing a wide variety of endogenous and exogenous substrates, Mrp1 plays important physiological roles in multiple tissues and also protects normal tissues against toxicants. However, the role of MRP1 in heart is largely unknown. The role of Mrp1 in DOX-induced cardiotoxicity was investigated in Mrp1 null (Mrp1-/-) and their C57BL (WT) littermates. Chronic DOX caused body weight loss and hemotoxicity, and these adverse effects were significantly exacerbated in Mrp1-/vs WT mice. Importantly, loss of Mrp1 potentiated DOX-induced cardiotoxicity, presenting as worsened cardiac function and more cellular apoptosis in DOX treated Mrp1-/mice. Mrp1 also protected neonatal mouse cardiomyocytes (CM) and cardiac fibroblasts (CF) culture against DOX cytotoxicity in vitro. This was demonstrated by the decreased cell survival, more apoptosis and more DNA damage in DOX treated Mrp1-/vs WT cells. In addition, the effects of deletion of Mrp1 was studied on glutathione (GSH)/glutathione disulfide (GSSG) homeostasis, glutathione conjugate of 4hydroxy-2-nonenal (GS-HNE) accumulation, protein oxidative damage and expression of antioxidant enzymes. Loss of Mrp1 led to significantly higher GSH and GSSG basal levels in heart. Following DOX treatment, Mrp1-/CM and CF showed increased GSH and GSSG levels vs WT cells. Meanwhile, DOX increased expression of the GSH synthesis enzymes in Mrp1-/but not WT cells. Thus, increased GSH synthesis may contribute to the further increase in the GSH pool in DOX-treated Mrp1-/cells. DOX induced comparable increases of GS-HNE concentration in WT and Mrp1-/mice hearts. Finally, expression of extracellular superoxide dismutase (ECSOD/SOD3) was significantly lower in Mrp1-/vs. WT CM treated with either saline or DOX. In summary, this study is the first to document a protective role of Mrp1 in DOX-induced cardiotoxicity. It gives critical information regarding the potential adverse sequelae of introduction of MRP1 inhibitors as adjuncts to clinical chemotherapy of multidrug resistant tumors.
An economic perspective of dementia care in Ireland:maximising benefits and maintaining cost efficiency

Dementia is a major health issue and a global condition. Increasing prevalence, costs and burden of disease assert significant pressure on economic and social systems in many countries. Globally costs for people with dementia amount to more than 1% of gross domestic product (GDP)[1]. Concurrently, the World Health Organisation [2]observes a growing gap between budget allocation and the associated burden of mental health disorders, particularly in higher income countries. Point in care, the economic burden of dementia ranks higher than stroke, heart disease and cancer combined [3], however health care allocations for dementia continue to be substantially lower than each of these individual disease groups. Given the multiple agents who are involved in dementia care, ascertaining expenditure has inherent difficulties. A common indicator is investment on long term care, which is the composite of institutional and community based home care. Figure 1 compares spend (as a percentage of GDP) on long term care for both public and private sectors[4]. In terms of percentage of GDP, Ireland spends approximately half the OECD average. More importantly, UK, Canada and Australia where dementia specific strategies have been implemented shows show sizable differences. Ireland is predicted to have the largest growth in the older population of all European countries in the coming decades[5]. In real terms, the population is predicted to increase threefold and with this so will the demand for dementia specific services. Given the prognosis of dementia combined with predicted economic impacts, the WHO indicate that the key priority for dementia is targeted interventions towards the carer.
Quality of Female Sexual Function After Conventional Abdominal Hysterectomy - Three Month' Observation

Summary Introduction. Many medical and conservative surgical treatment options are available but still hysterectomy remains the most common gynecological procedure performed worldwide. These procedures are performed because of actual and possible malignant diseases, and benign conditions including pelvic pain, dyspareunia, uterine myomas, adenomyosis, endometriosis, and menometrorrhagia. The impact of hysterectomy on sexual function has always been a great concern to women and is a major source of preoperative anxiety. Data regarding the impact of hysterectomy on women's sexual functioning are not clear and consistent, many women report improvement of sexual functioning after hysterectomy, which may be due to relief of symptoms, while others complain of sexual dysfunction as a result of hysterectomy. Also discussion about advantages of cervix sparing operations is still controversial. Aim of the study. Aim was to assess and compare pre- and post-operative quality of sexual life of gynecological patients undergoing planned hysterectomy, and to find out opinions of patients and their partners about expected impact of operation and changes after surgery. Material and methods. Questionnaire method was used to survey gynecologic patients undergoing planned subtotal / total hysterectomy due to benign indication. Sexual Quality of Life Questionnaire – Female (SQoL-F) was used to assess quality of sexual life before and after surgery. Questions about other influencing factors and patients' opinions before and after operation were added. 38 completed questionnaires were used for data analysis. Results. Only 55% of subtotal hysterectomy group and 38.9% of total hysterectomy group told their partners completely about planned surgery. Mean period of beginning sexual activities after operation was 5.15 weeks after surgery in subtotal hysterectomy and 5.78 weeks in total hysterectomy group. SQoL-F after three months post-operation period was 6.50 points less in total hysterectomy group, which was not statistically significant. There was a slight statistically insignificant decrease of SQoL-F points within each group after three months observation period: -0.44 points in subtotal hysterectomy group and -2.47 points in total hysterectomy group. Although patients of total hysterectomy more frequently (22.2% vs. 5%) indicated negative impact on sexual function after operation, differences were not statistically significant. There were no differences in co-morbidities, concomitant medications, hormone use history and post-operative complications between groups. Conclusions. Patients before hysterectomy are worried about possible negative impact of surgery on their sexual function, they do not talk to their partners candidly about planned surgery. There were no statistically significant changes of sexual quality of life found after subtotal and total abdominal hysterectomy operation after three months observation period.
Essential obstetrics and gynaecology

Section 1 Essential reproductive science 1. Anatomy of the female pelvis Caroline de Costa 2. Conception and nidation Roger Pepperell 3. Physiological changes in pregnancy Fiona Broughton Pipkin 4. Placental and fetal growth and development E. Malcolm Symonds 5. Perinatal and maternal mortality Boon H. Lim Section 2 Essential obstetrics 6. History taking and examination in obstetrics Edwin Chandraharan 7. Normal pregnancy and antenatal care Shaylee Iles 8. Obstetric disorders Henry G. Murray 9. Maternal medicine Suzanne V.F. Wallace, Henry G. Murray and David James 1. Assessment of fetal wellbeing David James and Suzanne V.F. Wallace 11. Management of labour Sabaratnam Arulkumaran 12. Management of delivery Aldo Vacca 13. Postpartum problems Shankari Arulkumaran 14. Psychiatric disorders of childbirth Margaret R. Oates Section 3 Essential gynaecology 15. Basic clinical skills in gynaecology Ian M. Symonds 16. Gynaecological disorders Ian S. Fraser 17. Infertility William Ledger 18. Early pregnancy care Ian M. Symonds 19. Sexual and reproductive health Roger Pepperell 2. Gynaecological oncology Hextan Y.S. Ngan and Karen Chan 21. Prolapse and disorders of the urinary tract Ajay Rane and Jay Iyer Appendices A: Principles of perioperative care
A Systematic Literature Review of Imaging Definitions for Detection of Bone and Bone Marrow Metastases in Neuroblastoma Patients

Objective: The presence of bone and bone marrow (BM) metastases in neuroblastoma patients are independent adverse prognostic factors, so precise and consistent definitions of both categories on imaging are important. The objectives of this systematic review were to identify all definitions reported for detection of bone and bone marrow metastases on imaging in neuroblastoma to determine diagnostic accuracies of the most frequently used definitions for detection of bone and/or BM metastases on each imaging technique. Methods: We searched MEDLINE/PubMed (1945 to April 2013) and EMBASE/Ovid (1980 to April 2013). Full-text original studies were included if they reported definitions of bone and/or BM metastases on diagnostic imaging of children with suspected metastatic neuroblastoma. As reference standard for bone metastases bone scintigraphy was used and for bone marrow metastases bone marrow biopsies/aspirates. Methodological quality was assessed. Results: Of 403 identified studies (plus one relevant reference), 131 were assessed in full-text and 31 finally included, 23 described BM metastases and 18 bone metastases. No uniform definitions of bone and bone marrow metastases were reported for each imaging method. On MIBG scintigraphy bone metastases were mostly defined as “focal” and BM metastases as “diffuse” and on MRI both definitions were used for BM metastases. The diagnostic accuracy of different diagnostic methods to detect bone (reference test bone scintigraphy) or BM (reference test bone marrow biopsies/ trephines) metastases varied widely. Conclusion: No uniform definitions of bone and bone marrow metastases were reported for each imaging method and concerning the diagnostic accuracy no general conclusions could be drawn.
VR simulation of interventional radiology and microsurgery

Currently trainees typically learn surgery techniques directly on mocks, animals or cadavers. For safety, cost and ethics reasons, one cannot try all possible strategies to achieve efficient learning. Virtual Reality (VR) based surgery training systems introduce a complementary alternative in surgery training and education, which will enable more effective and systematic training, provide objective assessment of technical competence, facilitate the teaching of rare cases, and enable to test the future surgeons. However, to be a useful training tool, surgery simulator must be visually and physically realistic. This dissertation investigates the training method and fast modeling algorithms for the purpose of surgery simulator. Different to conventional training approach, a strategy of using decomposition of complex surgery procedures into subtasks and using multisensory learning cues is proposed. Given the computational constraint of real-time simulation, several physics-based approaches of modeling rigid and deformable objects, (self-)collision detection and collision handling techniques are introduced and implemented. The developed algorithms are firstly tested in the simulation of interventional radiology (IR) procedures. The simulation environment allows to carry out the most common procedures: guidewire and catheter navigation, contrast dye injection to visualize the vessels, balloon angioplasty and stent placement. Moreover, visual details including the heartbeat as well as breathing are also considered. Finally, we present a VR based microsurgery simulator which applies and extends the above training strategy and algorithms. The training system demonstrates a complete vascular suturing procedure and a series of decomposed subtasks. Using a novel haptic forceps, a user can learn principle microsurgery skills such as grasping, suture placement, needle insertion and knot-tying.