Miracle-dz/UniFAR-FTUs huggingface dataset:
PENGARUH PEMBERIAN KRIM TOPIKAL EKSTRAK BUAH NAGA MERAH (Hylocereus polyrhizuz) PADA LUKA AKUT TERHADAP KADAR INTERLEUKIN-6 FASE INFLAMASI

ABSTRACT Pendahuluan : Sitokinin berperan penting pada penyembuhan luka, salah satu sitokain yang berperan pada proses penyembuhan luka adalah interleukin-6 (IL-6). Penggunaan buah naga merah sebagai modalitas penyembuhan luka menjadi salah satu alternatif perawatan. Sayangnya masih sangat terbatas penelitian yang melaporkan penggunaan buah naga merah pada penyembuhan luka. Tujuan penelitian ini untuk mengindentifikasi efek dari pemberian Ekstrak Buah Naga Merah (EBNM) secara topikal terhadap kadar IL-6 pada penyembuhan luka akut pada wistar. Metode: Penelitian ini merupakan penelitian ekperimen dengan desain Randomized Post Test Control Group, dimana wistar jantan albino (n=41) berat badan 250-300 gr dibagi ke dalam 3 kelompok (control negatif (n=12), control positif (n=12), EBNM 7,5% (n=12)). Wistar dilukai pada punggung kiri dan kanan menggunakan Punch Biopsi 5 mm, selanjutnya kadar IL-6 diperiksa melalui serum dengan teknik ELISA. Data dianalisis menggunakan uji One Way Anova menggunakan SPSS 22 dengan nilai p < 0,05. Hasil: Pada hari ke-7, kadar IL-6 pada kelompok EBNM (101.9±32,2) lebih rendah dibandingkan kelompok control negatif (142,4±85,0) dan tidak lebih inferior dari kontrol positif (97.9±41.9). Pada hari ke-17, diameter luka lebih kecil pada kelompok EBNM (2.66±1.505) dibandingkan kelompok positif (3.16±0.516) dan kontrol negatif (4.33±0.707). Kesimpulan: Krim topikal EBNM 7,5% mempercepat penyembuhan luka yang ditandai dengan pengecilan diameter luka, yang disertai dengan penurunan kadar IL-6 yang sama baiknya dengan kontrol positif pada hari ke-7.
Being a Child Is a “Serious Game”: Innovations in Psychological Preventive Programs Against Child Sexual Abuse

The aim of this chapter is to analyze the main and most recent research trends for the prevention of Child Sexual Abuse (CSA), by summarizing and discussing related theoretical and methodological issues, debated among scholars. Starting from European and International recommendations, the authors will focus on the most innovative approaches and prevention programs, by particularly exploring the necessity to reinforce children’s ability to self-protect, the need for involving trusted adults in prevention programs, and the possibility to adopt serious games as innovative and child-appropriated tools to this end.
Efficacy of Biofeedback Therapy in Clinical Practice for the Management of Chronic Constipation and Fecal Incontinence

Abstract Background Chronic constipation (CC) and fecal incontinence (FI) are often secondary to pelvic floor neuromuscular sensory or motor dysfunction. Biofeedback therapy (BFT) uses visual and verbal feedback to improve anorectal coordination, strength and sensation. In clinical trials, BFT demonstrated response rates between 70% and 80%. The purpose of this study is to determine the effectiveness of BFT in clinical practice. Methods In this retrospective observational cohort study, the charts of all patients who completed BFT at our centre were reviewed. A positive response to BFT was defined as improvement in ARM profile from baseline or subjective symptom improvement or both. Descriptive statistics were used to analyze the data. Results One hundred thirty patients with an average age of 57.5 ± 16.4 years and 79.2% female were included. Of all patients, 43.1% were referred for CC, 37.7% for FI, 16.9% for alternating CC and FI, and 2.3% for rectal pain. The overall response rate to BFT was 76.2% (n=99). Of those that responded, 64.6% (n=64) demonstrated both ARM and symptom improvement, 27.3% (n=27) had ARM improvement but no symptom improvement, and 8.1% (n=8) had symptom improvement but no ARM improvement. In patients with FI, the overall response rate was 79.6% (n=39) with symptom improvement in 67.3% (n=33). In those with CC with dyssynergic defecation (n=53), the overall response rate was 69.8% (n=37); however, only 45.3% (n=24) had symptomatic improvement. Conclusion In our clinical practice, although overall response rates to BFT are similar to published reports, patients with CC with dyssynergic defecation are less likely to have symptomatic response compared with those with FI.
The use of small field of view 3T MRI for identification of articular cartilage defects in the canine stifle: An ex vivo cadaveric study

Noninvasive identification of canine articular cartilage injuries is challenging. The objective of this prospective, cadaveric, diagnostic accuracy study was to determine if small field-of-view, three tesla magnetic resonance imaging (MRI) was an accurate method for identifying experimentally induced cartilage defects in canine stifle joints. Forty-two canine cadaveric stifles (n = 6/group) were treated with sham control, 0.5, 1.0, or 3.0 mm deep defects in the medial or lateral femoral condyle. Proton density-weighted, T1-weighted, fast-low angle shot, and T2 maps were generated in dorsal and sagittal planes. Defect location and size were independently determined by two evaluators and compared to histologic measurements. Accuracy of MRI was determined using concordance correlation coefficients. Defects were identified correctly in 98.8% (Evaluator 1) and 98.2% (Evaluator 2) of joints. Concordance correlation coefficients between MRI and histopathology were greater for defect depth (Evaluator 1: 0.68-0.84; Evaluator 2: 0.76-0.83) compared to width (Evaluator 1: 0.30-0.54; Evaluator 2: 0.48-0.68). However, MRI overestimated defect depth (histopathology: 1.65 ± 0.94 mm; Evaluator 1, range of means: 2.07-2.38 mm; Evaluator 2, range of means: 2-2.2 mm) and width (histopathology: 6.98 ± 1.32 mm; Evaluator 1, range of means: 8.33-8.8 mm; Evaluator 2, range of means: 6.64-7.16 mm). Using the paired t-test, the mean T2 relaxation time of cartilage defects was significantly greater than the mean T2 relaxation time of adjacent normal cartilage for both evaluators (P < 0.0001). Findings indicated that MRI is an accurate method for identifying cartilage defects in the cadaveric canine stifle. Additional studies are needed to determine the in vivo accuracy of this method.
Obstructive sleep apnoea in patients undergoing cardiac surgery: Screening, postoperative outcomes and perioperative care

Obstructive sleep apnoea (OSA) is common and high prevalence has been described amongst patients undergoing cardiac revascularisation surgery. An excess of postoperative complications has been reported in patients with untreated Obstructive Sleep Apnoea (OSA) following surgical procedures, including those undergoing cardiac surgery. This has led some clinicians towards pre-operative screening for OSA though the best screening methodology has not yet been established. Moreover, the effect of screening and of treatment for OSA on surgical outcomes remains unknown. Does current evidence justify screening and treating patients before they present for surgery? Is this leading to potential delay in surgery whilst awaiting sleep diagnostics and commencing the treatment? This review article will examine the available evidence base and endeavour to answer these questions and identify implications for future research.
Arterial Stiffness and Abdominal Aortic Aneurysm: The effect of acute exercise

Abdominal aortic aneurysm (AAA) is a localised dilatation of the abdominal aorta leading to an increase in normal diameter by >50%. AAA accounts for approximately 2% of all deaths worldwide (Upchurch and Schaub 2006). Surgical repair is the only current treatment option but only available for patients with large AAA (≥55mm) (Nordon, Hinchliffe et al. 2011) leaving patients with small AAA (≤55 mm) with no treatment options. Increased arterial stiffness is a key factor characterising the development and growth of an AAA (Raaz, Zollner et al. 2015) and likely contributes to elevated cardiovascular mortality in patients with small AAA (Golledge, Muller et al. 2006, Bath, Gokani et al. 2015). Therefore, arterial stiffness could be used as an important treatment target in order to delay aneurysm progression and reduce cardiovascular risk. Arterial stiffness is reduced with increased cardiorespiratory fitness (Gando, Murakami et al. 2016) and aerobic-exercise training in older adults (Fujie, Sato et al. 2014). These adaptations are attributed to the frequent, repetitive haemodynamic perturbations associated with each bout of exercise (Green, Hopman et al. 2017). A single bout of exercise transiently lowers arterial stiffness in healthy adults (Kingwell, Berry et al. 1997, Mutter, Cooke et al. 2017), is commonly accompanied by short-term improvements in arterial function and central blood pressure (Millen, Woodiwiss et al. 2016) and may be dependent on exercise intensity (Tordi, Mourot et al. 2010). However, in adults with cardiovascular comorbidities commonly observed in patients with AAA, excessive increases in arterial stiffness during and after exercise (Shim, Yang et al. 2011, Gkaliagkousi, Gavriilaki et al. 2014, Bunsawat, Ranadive et al. 2017) may transiently exacerbate cardiovascular risk (Schultz, La Gerche et al. 2017). To date, little is known about the haemodynamic effects of acute exercise in patients with AAA. Determining the arterial stiffness response to exercise would provide better understanding of the short-term risks and benefits of exercise in patents with AAA, and an insight into the potential efficacy of exercise for reducing arterial stiffness and cardiovascular risk. Hence, this thesis aimed to determine the effect of a single bout of exercise on the post-exercise arterial stiffness response between patients with AAA and healthy older adults. As patients with AAA are older and with low levels of cardiorespiratory fitness, this thesis also explored the effects of cardiorespiratory fitness and exercise intensity on post-exercise arterial stiffness, in healthy older adults. Additionally, this thesis aimed to establish the reliability of its measurements by assessing the reliability of post-exercise changes in arterial stiffness in older healthy adults. ; Submitted in the fulfilment of the requirements of the degree of Doctor of Philosophy, University of the Sunshine Coast, 2018.
Does stabilizing input pressure orthosis vest, lycra-based compression orthosis, improve trunk posture and prevent hip lateralization in children with cerebral palsy?

Objectives This study aims to investigate whether the use of a lycra-based compression orthosis known as stabilizing input pressure orthosis (SPIO) vest improves trunk posture and hip lateralization in children with cerebral palsy (CP) and to compare the effects of two- and six-hours daily wear of the orthosis. Patients and methods Between December 2013 and July 2015, a total of 24 children with CP (5 boys, 19 girls; mean age 61.1 months; range 35 to 105 months) with impaired trunk control were included in this single-blind, randomized-controlled study. All were randomized to either of the three groups as the control group (received only conventional exercise therapy), the SPIO 2-hour group (worn orthosis two hours during therapy), and the SPIO 6-hour group (worn orthosis four hours in addition to two hours of wear during therapy). The Sitting Assessment Scale (SAS), Cobb angle, kyphotic angle, and Migration Index were used to evaluate the trunk posture and hip lateralization before treatment and at six months after treatment. Results The SAS scores improved compared to baseline in all groups. The Cobb angle and kyphotic angle showed a significant decrease at six months after treatment only in the SPIO groups, while intra-group analysis of the Migration Index did not show a statistically significant difference. Changes in the radiographic assessments were similar among the groups, except for the kyphotic angles. The kyphotic angle showed less change in the control group. Comparison of the SPIO groups showed no significant differences in terms of the variables assessed. Conclusion The SPIO vest improves the kyphotic posture, but not scoliosis and hip lateralization in children with CP with impaired trunk control when used in combination with the conventional therapy. Using the SPIO vest for two and six hours also yields similar outcomes.
Uncoupling of Oxygen and Glucose Metabolism in Persistent Crossed Cerebellar Diaschisis

Background and Purpose—The pathophysiology of deafferentation-induced changes after stroke remains unclear. Some supratentorial strokes cause persistent decreases in blood flow and metabolism in the contralateral cerebellum (persistent crossed cerebellar diaschisis[CCD]). Our previous study showed uncoupling of oxygen consumption and blood flow in this condition, which may reflect a characteristic change in brain metabolism caused by deafferentation. This uncoupling might be related to oxidation of some substrates other than blood-borne glucose, which could also lead to the uncoupling of oxygen consumption and glucose utilization. The purpose of this study was to investigate whether oxygen consumption is uncoupled from glucose utilization in persistent CCD. Methods—Using positron emission tomography in 10 unilateral supratentorial stroke patients, we evaluated regional blood flow, oxygen consumption, and glucose utilization in the cerebellar cortex in the chronic stage. Eight patients with a significant c.
Oral versus vaginal misoprostol for induction of labor

OBJECTIVES: The aim of this randomized controlled trial is to compare the safety and efficacy of titrated oral misoprostol with vaginal misoprostol for labor induction. METHODS: 778 patients at term meeting inclusion criteria for induction of labor were randomized by computer generated block randomization sequence. They were allocated into two groups to receive oral drug and vaginal placebo or vaginal drug and oral placebo given every 4 hourly until the patient entered active labor or the bishop score of the cervix was more than 6. The dosage of the oral drug was 50 mcg of misoprostol followed by 2 doses of 100 mcg each and that of the vaginal drug was 25 mcg in all three doses. The results were analyzed using SPSS version 17 software. RESULTS: 389 women were equally randomized to each arm. Vaginal delivery in 24 hours from induction was achieved in 67% and 66.8% of the vaginal and oral misoprostol group respectively. The rate of cesarean section rate, incidence of uterine hyperstimulation and meconium staining were similar in both the groups. The need for oxytocin augmentation was less in the oral misoprostol group (80.3% versus 73.4%, p=0.02). The incidence of maternal or neonatal outcomes was similar. Our study found that oral misoprostol is as safe and effective as vaginal misoprostol for cervical ripening. CONCLUSION: Our study found that oral misoprostol is as effective as vaginal misoprostol for cervical ripening and in achieving vaginal delivery within 24 hours. The rate of hyperstimulation and cesarean section was similar in both the groups. The need for oxytocin augmentation was less in the oral misoprostol group. Oral misoprostol had no increase in the incidence of maternal or neonatal outcomes compared to vaginal misoprostol.
Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance

This AASLD 2018 Hepatitis B Guidance is intended to complement the AASLD 2016 Practice Guidelines for Treatment of Chronic Hepatitis B and update the previous hepatitis B virus (HBV) guidelines from 2009. The 2018 updated guidance on chronic hepatitis B (CHB) includes (1) updates on treatment since the 2016 HBV guidelines (notably the use of tenofovir alafenamide) and guidance on (2) screening, counseling, and prevention; (3) specialized virological and serological tests; (4) monitoring of untreated patients; and (5) treatment of hepatitis B in special populations, including persons with viral coinfections, acute hepatitis B, recipients of immunosuppressive therapy, and transplant recipients. The AASLD 2018 Hepatitis B Guidance provides a data-supported approach to screening, prevention, diagnosis, and clinical management of patients with hepatitis B. It differs from the published 2016 AASLD guidelines, which conducted systematic reviews and used a multidisciplinary panel of experts to rate the quality (level) of the evidence and the strength of each recommendation using the Grading of Recommendations Assessment, Development and Evaluation system in support of guideline recommendations. In contrast, this guidance document was developed by consensus of an expert panel, without formal systematic review or use of the Grading of Recommendations Assessment, Development, and Evaluation system. The 2018 guidance is based upon the following: (1) formal review and analysis of published literature on the topics; (2) World Health Organization guidance on prevention, care, and treatment of CHB; and (3) the authors’ experience in acute hepatitis B andCHB. Intended for use by health care providers, this guidance identifies preferred approaches to the diagnostic, therapeutic, and preventive aspects of care for patients with CHB. As with clinical practice guidelines, it provides general guidance to optimize the care of the
Angiotensin II Antagonist Prevents Electrical Remodeling in Atrial Fibrillation

Background—The blockade of angiotensin II (Ang II) formation has protective effects on cardiovascular tissue; however, the role of Ang II in atrial electrical remodeling is unknown. The purpose of this study was to investigate the effects of candesartan and captopril on atrial electrical remodeling. Methods and Results—In 24 dogs, the atrial effective refractory period (AERP) was measured before, during, and after rapid atrial pacing. Rapid atrial pacing at 800 bpm was maintained for 180 minutes. The infusion of saline (n=8), candesartan (n=5), captopril (n=6), or Ang II (n=5) was initiated 30 minutes before rapid pacing and continued throughout the study. In the saline group, AERP was significantly shortened during rapid atrial pacing (from 149±11 to 132±16 ms, P<0.01). There was no significant difference in AERP shortening between the saline group and the Ang II group. However, in the candesartan and captopril groups, shortening of the AERP after rapid pacing was completely inhibited (from 142±9 to 147±.
Fall risks factors among home-based health care patients in the Aseer province: Observational study

Purpose: To describe the prevalence of fall risks factors using the Missouri Alliance for Home Care’s fall risk assessment tool (MAHC-10) on home-based health care (HHC) patients in the Aseer region, southern Saudi Arabia. Also, to highlight the process of care, and physical therapy utilization among home health care beneficiaries. Method: 242 patients’ information were retrieved and reviewed. Patients in our study received various healthcare services including physical therapy, nursing and physicians’ visits between October and December 2017. We used the MAHC-10, which was designed for assessing multifactorial fall risks among home-based health care patients. Results: 43% of patients were male, and 57% were female. Males received care within an average of 8 d of a referral date, whereas female patients received care within an average of 15 d. Majority of patients are functionally dependent (78%) of patients. Nursing visits were the highest number of professionals that provided HHC visits for both patients’ risk groups. The impairment of functional mobility had the highest fall risk factor among patients receiving HHC services, and fall history factor was the lowest prevalent fall risk factor among patients. Conclusion: Health care utilization is very important, and it should start early enough to decrease the risk of fall especially physical therapy visits. The level of functional mobility was also a most prevalent factor across all home health care patients in our study, and it is an essential element for predicting the likelihood of a fall in the older adult Aseer population.
Can transcranial direct current stimulation enhance brain activities?

Transcranial Direct Current Stimulation (tDCS) has increasingly purposive treatments for neurorehabilitation, compared to other noninvasive neuromodulations. It is inexpensive, easy to administer after well trained, portable, and home used design considered as the most cost effective and good compliance therapy. It can either enhance or suppress cortical excitability by a weak and constant direct current applied to the brain. It has effect for several hours after the stimulation, depending on several factors. Three different stimulation types are as the followings; (1) anodal stimulation, the anodal electrode (+) and the reference electrode are applied over the lesioned brain area and the contralateral orbit, respectively. It effects subthreshold depolarization, producing neural excitation. ; (2) cathodal stimulation, the cathode (−) and the reference electrode are applied over the non-lesioned brain area and the contralateral orbit, respectively. It effects subthreshold polarization, suppressing neural activity. ; (3) Dual tDCS, anodal and cathodal stimulation, the anodal electrode (+) and the cathodal electrode (−) are applied over the lesioned and non-lesioned brain, respectively. In clinical use, two (or more) electrodes are applied over the scalp with the current flowing from the anodal to the cathodal electrode. The strength of electrical currents cannot produce an action potential.1,2 The factors influence neural activity including the state of the brain during stimulation at rest or stimulation and relearning with a task in the meantime, and even the time of the day. There are increasing evidences of tDCS effect on the whole brain networks by stimulating just one brain region.3 The positive clinical effects of tDCS in various disorders are caused by the complex interactions between the associated brain network and the area of stimulation. Interestingly, stimulation at the dorsolateral prefrontal cortex (DLPFC), have shown the effectiveness for several conditions. On the other hand, different area of stimulation for the same disorder have shown to have similar results. These new evidences may indicate an underlying neural network for disorders and may suggest network stimulation as a new stimulation protocol.3
Single high-dose oral vitamin D3 treatment in New Zealand children with inflammatory bowel disease.

Background High-dose oral vitamin D (stoss) is a novel treatment in children with inflammatory bowel disease (IBD). Vitamin D supplementation may have benefits in IBD beyond bone health including reduced disease activity and improvements in inflammatory markers. The aim of this study was to retrospectively assess the efficacy, safety and impact on disease activity of single oral high-dose vitamin D3 therapy in New Zealand (NZ) children with IBD and vitamin D deficiency. Methods In this retrospective chart review, children with IBD and vitamin D deficiency [serum 25-OH vitamin D level (25-OHD) <50 nmol/L] in Christchurch, NZ, who were managed with single high-dose vitamin D3 therapy were identified. Measurements of serum 25-OHD, calcium and standard serum inflammatory markers prior to and up to 6 months following stoss therapy were extracted from patient records. Disease activity was also defined using the Pediatric Crohn's Disease (CD) Activity Index (PCDAI) at time points before and 3 months following stoss. Results Twenty-eight doses of stoss were given to 23 children, aged 3-16 years. Mean 25-OHD levels increased after stoss therapy from 39 nmol/L (95% CI: 37-42 nmol/L) at baseline to 189 nmol/L (148-231 nmol/L) at 1-2 months (P<0.001). All children with 1 month levels measured achieved 25-OHD >75 nmol/L. One child had a serum calcium of 2.7 (normal range, 2.2 to 2.6 mmol/L) 2 weeks after treatment, which normalized on repeat testing 10 days later. PCDAI scores, mean platelet count, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) all reduced significantly from baseline to 3 months following stoss therapy. Conclusions Single high-dose oral vitamin D therapy was used successfully and safely to manage vitamin D deficiency in these children with IBD. An improvement in inflammatory markers and disease activity scores also occurred following stoss therapy.