Miracle-dz/UniFAR-FTUs huggingface dataset:
An effective interferon‐gamma‐mediated inhibition of hepatitis C virus replication by natural killer cells is associated with spontaneous clearance of acute hepatitis C in human immunodeficiency virus‐positive patients

Hepatitis C virus (HCV) coinfection is an increasing health problem in human immunodeficiency virus‐positive (HIV+) individuals. However, a considerable proportion of HIV+ patients manage to overcome acute hepatitis C (AHC) spontaneously. In the present study, we analyzed the role of natural killer (NK) cells in modulating the course of AHC in HIV+ patients. Twenty‐seven HIV+ patients with AHC (self‐limited course: n = 10; chronic course: n = 17), 12 HIV+ patients with chronic hepatitis C (CHC), 8 HIV monoinfected individuals, and 12 healthy controls were studied. NK cells were phenotypically analyzed by flow cytometry. Interferon‐gamma (IFN‐γ) secretion, degranulation (CD107a), and anti‐HCV (= inhibition of HCV replication) activity of NK subpopulations were analyzed using the HuH7A2HCVreplicon cell system. NK cell frequency did not differ significantly between HIV+ patients with chronic and self‐limited course of AHC. However, we found NK cells from patients with self‐limiting infection to be significantly more effective in inhibiting HCV replication in vitro than NK cells from patients developing CHC. Of note, antiviral NK cell activity showed no significant correlation with NK cell degranulation, but was positively correlated with IFN‐γ secretion, and blocking experiments confirmed an important role for IFN‐γ in NK cell‐mediated inhibition of HCV replication. Accordingly, NK cells from patients that spontaneously cleared the virus displayed a stronger IFN‐γ secretion than those developing chronic infection. Finally, we observed high expression of NKG2D and NKp46, respectively, to be associated with self‐limiting course of aHCV. Accordingly, we found that blocking of these NK cell receptors significantly impaired antiviral NK cell activity. Conclusion: Our data suggest a strong IFN‐γ‐mediated antiviral NK cell response to be associated with a self‐limited course of AHC in HIV+ patients. (Hepatology 2014;59:814–827)
Serum Uric acid level in preeclampsia and its correlation to maternal and fetal outcome

Introduction: Preeclampsia and Eclampsia are serious complications of pregnancy. They are the leading causes of morbidity and mortality in the world and one of the leading causes for perinatal mortality also. Biochemical parameters like serum levels of Urea, Uric Acid, Creatinine, LDH, Transaminases increase significantly in Preeclampsia/eclampsia. Aim of the study: Aim of the study was to Estimate the level of serum uric acid in preeclampsia/eclampsia, Correlate Hyperuricemia with the severity of Preeclampsia and Study its effect on maternal and fetal outcome. Study design: Prospective study, conducted at the Government Lady Goschen Hospital, Mangalore, Karnataka India, during the years from June 1997 to June 1999, with recent updates. Method: 100 consecutive patients with preeclampsia/Eclampsia all having singleton pregnancy were included in the study. Necessary laboratory investigations from samples of blood and urine were performed. Special investigations like Ultrasonography and fundoscopy were conducted. Maternal and perinatal complications were studied in patients with preeclampsia with elevated uric acid levels. Results: In patients with serum uric acid level of >5.5mg/dl, 86.4% had perinatal deaths and 60 % of patients with uric acid levels > 5.5 mg/dl had preterm delivery. All the babies born to mothers who had this value had birth weight < 2.5 kgs, 68% of them being Small for Gestational Age. Conclusions: Hence by serial monitoring of serum Uric acid level we would be able to ascertain the severity and progression of the disease process and prompt termination of pregnancy would prevent maternal complications, improve fetal outcome and reduce perinatal mortality
The Life-Saving Effectiveness of Body Armor for Police Officers

The objective of this study was to determine the effect of protective body armor on a police officer's risk of being killed and estimate the benefits and costs of outfitting police with body armor. In the United States, for police shot in the torso from 2004 to 2007 (n = 262), we calculate the relative risk of death from a gunshot without and with body armor. We estimate the benefit of body armor using the willingness-to-pay approach and compare it with the cost of supplying armor to police not currently wearing armor. The results show that the relative risk of dying without armor is = 3.4 (95% CI: 2.4 to 4.6). Outfitting all police with armor would save at least 8.5 lives per year, resulting in a benefit that is nearly twice the cost, or a net benefit of ∼$100/officer. Body armor more than triples the likelihood that a police officer will survive a shooting to the torso. Outfitting all police with armor yields a positive net benefit and is strongly justified economically.
Mapping Particulate Matter at the Body Weld Department in an Automobile Assembly Plant

A respiratory health survey conducted in an assembly plant in 2000–2001 found that welders had elevated rates of self-reported respiratory symptoms compared with painters and assembly workers. Subsequently, the ventilation system was improved at the body weld department. In a follow-up study, particle spatial distributions were analyzed, following a mapping protocol developed specifically for this workplace, to evaluate the effectiveness of the changes. Significant temporal and spatial variations were observed. Temporal variation during a shift was monitored with over-shift stationary sampling at fixed locations. Spatial variation was evaluated with 1-min time-weighted average particle concentrations measured throughout the process areas (212 locations). The arithmetic spatial mean across 212 locations for the respirable particles varied from 305 μg/m3 to 501 μg/m3 on 6 sampled days, with a standard deviation of 71 μg/m3, indicating that the difference between before and after countermeasures must be at least 191 μg/m3 to be considered statistically significant at the given sample sizes. The available data were not sufficient to evaluate the reduction of the particle concentrations after the countermeasures. The map of particle mass concentration revealed several high concentration areas, requiring further investigation and potentially higher level of controls. Resistance welding needed to be effectively controlled, as it could be the major particle emitting sources in the facility. The map of submicrometer (0.014 μm to 1.0 μm) particle count concentration presented different patterns from that of respirable particle mass concentration, indicating that the submicrometer particles tended to be more evenly distributed over the process areas. Workers not in proximity to intensive welding operations might be exposed to fine particles at levels higher than had traditionally been thought. Mapping was demonstrated to be an effective method to assess particle spatial distributions. A well-designed sampling protocol is critical to achieving the specific aims of a mapping study.
Psychologist and Physician Interest in Telehealth Training and Referral for Mental Health Services: An Exploratory Study

The current study explored psychological and medical professionals’ interest in videoconferencing telehealth training and mental health telehealth referral. An online survey assessed 782 participants comprised of 669 psychological (45% male, Mean Age = 47.01, SD = 16.82) and 113 medical professionals (58% male, Mean Age = 46.19, SD = 12.40). Z-test analyses indicated that although psychological professionals were statistically more interested in receiving telehealth training, both groups reported some interest. Ranked responses indicated efficacy data, ethical issues, and legal concerns as the most endorsed areas of training interest. Referral concerns were also found. Findings were discussed related to both statistical and clinical significance. Application of findings is discussed related to future work, practice, and program creation. The development of telehealth training programs will provide interested professionals with tools required for practice and may serve as an impetus to increase utilization and/or referral.
Communication skills for consultations about mental health problems

Mental health problems are a common presenting complaint in general practice. Ninety percent of patients with mental health conditions are managed in primary care and more than a third of general practice consultations are linked to mental health conditions. Despite short consultation times, the GP can play a key role in helping people with mental health problems by communicating effectively and liaising with appropriate voluntary and community sector organisations. This article aims to discuss techniques that the GP can use to engage with people with mental health problems and prevent further morbidity and mortality.
Health promotion behaviors of residents with hypertension in Iwate, Japan and North Carolina, USA.

AIM The aim of this study was to compare the health promotion practises of rural residents in northern Japan (n = 212) to those in south-eastern North Carolina, USA (n = 105), using the Health Promotion Lifestyle II (HPLP) scale. METHODS A comparative and descriptive design examined the relationships between health-related behaviors and demographic and physiological variables, and compared cross-cultural patterns. RESULTS The Japanese participants scored significantly higher on the total HPLP II score, as well as on the subscales of health responsibility, nutrition, interpersonal support, and stress management. No significant differences were found in the HPLP II subscales for spiritual growth or physical activity between the groups. The subscale scores for both the participants from Japan and the participants from North Carolina were lowest for physical activity. For the participants from North Carolina, the HPLP II subscale scores were highest for spirituality and interpersonal relationships. The predictive factors of variation in the scores of the HPLP II for the participants from North Carolina included being married and not working. No significant demographic predictor was found for the HPLP II scores of the Japanese participants. CONCLUSIONS The study's findings add to an increased understanding of the cultural variations in the health-promoting behaviors of persons with hypertension. Providing health promotion strategies for hypertension remains an urgent issue for nurses and other health-care providers in both Japan and North Carolina, USA.
Measuring recovery of arm-hand function in stroke patients: A comparison of the Brunnstrom-Fugl-Meyer test and the Action Research Arm test

The purpose of this study was to compare two validated and reliable assessment scales — the Action Research Arm test and the Brunnstrom-Fugl-Meyer test — both of which provide numerical scores on an ordinal scale for motor and functional assessment of the arm in stroke patients. The change in scores on both assessment scales was quantified, as was the time needed to administer the tests. Fifty-three stroke patients admitted consecutively to hospital were examined on the two tests at two and eight weeks after the onset of stroke. The rank correlation coefficient between scores on the test indicates a significant relationship both at two (rs = 0.91) and eight (rs = 0.94) weeks (p < 0.001). The mean improvement on both tests appeared to measure arm-hand funtion equally well. Nevertheless, because the Action Research Arm test is a hierarchical scale and therefore requires less time to administer than the Brunnstrom-Fugl-Meyer test, it is recommended for follow-up of arm-hand function recovery after stroke.
Arterial hypertension associated with somatic pathology in present-day practice of internal diseases

Dynamics of regional and gender features of occurrence of arterial hypertension associated with diseases of gallbladder, biliary ducts and pancreas for 2003-2011 was analyzed. There researched 23,310 patients (9111 males and 14,188 females) treated in clinic of scientific centre of clinical and experimental medicine SB RAMS. Occurrence of such combination, depending on gender, residence (the Novosibirsk region (NR) or Yakutia) as well as in age subgroups (16-39, 40-59 and over 60) was estimated. Occurrence of arterial hypertension associated with diseases of gallbladder, biliary ducts and pancreas was observed more in male of Subgroup I, living in NR and Yakutia. In 2003-2008 in female of Subgroup III, living in NR comorbidity pathology was observed more frequently than in male. In Subgroup III in female of NR occurrence of combined pathology was maximum (36.6%) 2006-2008, in female of Yakutia—38.5% in 2003-2005. Dependence of occurrence of combined pathology on residence was observed in male. In 2003-2011 in male of Yakutia combined pathology was observed frequently than in male of NR. Occurrence of comorbidity pathology, depending on gender and age was typical for inhabitants of NR. In Group I comorbidity pathology was frequently observed in male, in Group III—in female. It is necessary to develop regional strategies for observing patients with combined pathologies to improve prevention, rehabilitation and treatment of patients with arterial hypertension associated with diseases of gallbladder, biliary ducts and pancreas.
Learning in the surgical workplace: necessity not luxury

Background: Surgical teaching and training has a long tradition of apprenticeship‐style mentoring, which has been widely revered and respected. The teaching style and learning was feared by some, but appreciated by all. The basis of this teaching was a strong relationship between teacher and trainee that was formed over many years of close working. However, modern legislation in the form of the European Working Time Directive (EWTD) has made this relationship difficult to achieve. Shifting working patterns have broken the continuity. We need to find new ways to learn the art of surgery and to maximise the limited time that is available on the ‘shop floor’.
Promoting musculoskeletal health through physical activity for all children and adolescents.

Decreased physical activity (PA) and increased sedentary behavior are major factors affecting overweight and obesity rates for all American children and adolescents. These behavioral changes have ultimately affected the musculoskeletal health and function for all American children and adolescents. In addition, these obesity trends have negative health effects of cardiovascular disease, metabolic syndromes, and decreased physical functioning, which last into adulthood (Ogden, Carroll, Curtin, Lamb, & Flegal, 2010). Overweight and obesity form the most signifi cant future healthcare risks for children and adolescents in the United States. Furthermore, children with special healthcare needs, such as physical disabilities, face additional threats to their musculoskeletal health.
Cohort Mortality Study of Roofing Granule Mine and Mill Workers. Part II. Epidemiologic Analysis, 1945–2004

The mortality of 2650 employees (93.4% males) in the mine and mill production of roofing granules at four plants was examined between 1945 and 2004. Hypotheses focused on diseases associated with exposure to silica: nonmalignant respiratory disease, lung cancer, and nonmalignant renal disease. Study eligibility required ≥ 1 year of employment by 2000. Work history and vital status were followed through 2004 with < 1% lost to follow-up. Industrial hygiene sampling data (1871 sampling measurements over a 32-year period) and professional judgment were used to construct 15 respirable crystalline silica exposure categories. A category was assigned to all plant-, department-, and time-dependent standard job titles. Cumulative respirable crystalline silica exposure (mg/m3-years) was calculated as the sum of the product of time spent and the average exposure for each plant-, department-, job-, and calendar-year combination. The cohort geometric mean was 0.17 mg/m3-years (geometric standard deviation 4.01) and differed by plant. Expected deaths were calculated using U.S. (entire cohort) and regional (each plant) mortality rates. Poisson regression was used for internal comparisons. For the entire cohort, 772 deaths (97.4% males) were identified (standardized mortality ratio 0.95, 95% CI 0.88–1.02). There were 50 deaths from nonmalignant respiratory diseases (1.14, 95% CI 0.85–1.51). Lagging exposure 15 years among the male cohort, the relative risks for nonmalignant respiratory disease were 1.00 (reference), 0.80, 1.94, and 2.03 (p value trend = 0.03) when cumulative exposure was categorized < 0.1, 0.1–<0.5, 0.5–<1.0, and ≥ 1.0 mg/m3-years, respectively. There was a total of 77 lung cancer deaths (1.11, 95% CI 0.88–1.39). Lagging exposure 15 years, the relative risks for males were 1.00 (reference), 1.83, 1.83, and 1.05 (p value trend = 0.9). There were 16 deaths from nonmalignant renal disease (1.76, 95% CI 1.01–2.86). This exposure-response trend was suggestive but imprecise. The study results are consistent with other cohorts with similar levels of exposure to respirable crystalline silica.
Job Strain and Shift Work Influences on Biomarkers and Subclinical Heart Disease Indicators: A Pilot Study

This pilot study is one of the first to examine the impact of job strain and shift work on both the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis using two salivary stress biomarkers and two subclinical heart disease indicators. This study also tested the feasibility of a rigorous biological sampling protocol in a busy workplace setting. Paramedics (n = 21) self-collected five salivary samples over 1 rest and 2 workdays. Samples were analyzed for α-amylase and cortisol diurnal slopes and daily production. Heart rate variability (HRV) was logged over 2 workdays with the Polar RS800 Heart Rate monitors. Endothelial functioning was measured using fingertip peripheral arterial tonometry. Job strain was ascertained using a paramedic-specific survey. The effects of job strain and shift work were examined by comparing paramedic types (dispatchers vs. ambulance attendants) and shift types (daytime vs. rotating day/night). Over 90% of all expected samples were collected and fell within expected normal ranges. Workday samples were significantly different from rest day samples. Dispatchers reported higher job strain than ambulance paramedics and exhibited reduced daily alpha-amylase production, elevated daily cortisol production, and reduced endothelial function. In comparison with daytime-only workers, rotating shift workers reported higher job strain, exhibited flatter α-amylase and cortisol diurnal slopes, reduced daily α-amylase production, elevated daily cortisol production, and reduced HRV and endothelial functioning. Despite non-statistically significant differences between group comparisons, the consistency of the overall trend in subjective and objective measures suggests that exposure to work stressors may lead to dysregulation in neuroendocrine activity and, over the long-term, to early signs of heart disease. Results suggest that further study is warranted in this population. Power calculations based on effect sizes in the shift type comparison suggest a study size of n = 250 may result in significant differences at p = 0.05. High compliance among paramedics to complete the intensive protocol suggests this study will be feasible in a larger population.
The Impact of Prehabilitation on Postoperative Functional Status, Healthcare Utilization, Pain, and Quality of Life: A Systematic Review

BACKGROUND: “Preoperative rehabilitation” or prehabilitation has been increasingly studied alongside the deleterious effects of surgery and functional decline. Prehabilitation is the preoperative optimization of physical functionality to enable the individual to maintain a normal level of function during and after surgery. This systematic review evaluates the effectiveness of prehabilitation on functional status, healthcare utilization, quality of life, and pain postoperatively. METHODS: Trials registries and databases of published and unpublished literature were extensively searched. All studies were assessed independently for relevance, eligibility, and quality. Seventeen studies were included in the review: 13 in orthopaedics (mainly knee or hip arthroplasty for osteoarthritis), 2 in abdominal surgery, and 2 in cardiac surgery. FINDINGS: There is no evidence to show that prehabilitation has significant benefits in function, quality of life, and pain; however, it may reduce admission to rehabilitation after knee or hip arthroplasty for osteoarthritis. There is insufficient evidence to make inferences in other surgical populations, notwithstanding initial evidence does not demonstrate advantages.
Acute Postoperative Pain Management

Anesthesiologists continue to practice pain medicine and contribute significantly to the scientific evolution of this most important subspecialty in modern health care. As the public becomes more aware of the incredible techniques that are now available to manage acute, chronic, and cancer pain, the expectation that there will be painless surgery and postoperative recovery increases. Thus, health care professionals must stay abreast of the advances in acute and chronic pain management and strive always to provide contemporary care. We have a potent arsenal of modalities that can effectively minimize the patient’s postoperative pain. Doing so prevents unnecessary patient discomfort, lengthy hospital stays, undue medical expenses, poor clinical outcomes, and extensive utilization of already overburdened health care resources (1–3). The clinical practice guidelines promulgated by the Agency for Health Care Policy and Research from 1992 encouraged clinicians to focus on providing effective acute postoperative pain management and proposed a systematic approach to doing so (4). The American Society of Anesthesiologists (ASA) has promulgated practice guidelines for acute pain management because this aspect of our contemporary practice is so essential (5). So significant are the benefits from treating pain effectively that the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is commanding that all institutions develop pain management programs as a criterion for regaining certification. The proposed guidelines identify the responsibilities of both the institution and the clinical staff, as well as delineate the patient’s rights. The JCAHO standards change the emphasis to patient satisfaction as an essential element that drives the clinical activity of health care professionals. The documentation of the preoperative assessment of the patient as to knowledge about and preferences for pain management techniques, as well as the teaching provided and an amplified postoperative evaluation protocol, become paramount in establishing hospital policy and clinical care. The ASA Committee on Pain Medicine considers the following as important for measurement of the effectiveness of pain intervention: subjective pain report, patient satisfaction, patient health perception, productivity (as to social, recreational, and vocational function), functionality in daily living, medical findings, mental health, health care utilization, and cost. These data are a powerful database that will continue to be validated. Todd and Brown (6) add vitality to this discussion in raising this timely question: how can we most firmly establish the true advantages of regional anesthesia and analgesia?