Miracle-dz/UniFAR-FTUs huggingface dataset:
The impact of music listening on hospice patients' acceptance of a good death: A qualitative study of hospice caregivers' perceptions

The current study served to provide new knowledge that may benefit future researchers, policy makers, health care leaders, and health care professionals who aspire to improve the delivery status for quality end of life care. A missing link in the hospice care continuum was identified as the need for the use of music listening by patients and caregivers as a low cost viable non-invasive alternative intervention that can be effectively utilized in real life situations. The researcher chose the current study’s generic qualitative design to enhance understanding of how informal hospice patients’ caregivers perceived music listening as a means for the patients to accept the state of a good death. Generic qualitative research design offered the researcher with an opportunity to hear and inductively analyze the hospice patients’ vulnerable voices per their caregivers. Data was collected during a semi-structured face-to-face interview process and was reflective of the perceptions of hospice caregivers (N = 4). The researcher incorporated an axial coding process with the use of NVivo 9 software to analyze the data. A priori coding method incorporated the use of four predetermined themes: three domains for the concept of a good death and one for music and a good death. Overall, the findings indicated that music listening had a positive effect on the hospice patients, according to their caregivers’ perceptions. The study limitations reflected the use of a small sample size from one Southwestern city that consisted of four female caregivers and the study results were dependent upon the perceptions of these caregivers. Consequently, due to the study’s limitations, health care researchers and health care administrators should cautiously generalize the study’s findings and decide for themselves if the study benefits outweigh its limitations. Further studies are indicated to enhance and supplement the knowledge presented in this study. One suggestion to further research is to broaden the scope of recruitment to include younger hospice patients, including children, who receive care either in their own home or in a medical facility. Another suggestion to further research would be to compare the effects of different types of music preferred by hospice
Standardizing Patient Handoff from the Emergency Department to the Stepdown Inpatient Unit

The standardization of the patient handoff has become more imperative with the ever-increasing implementation of the electronic health record. An area especially vulnerable for patient handoff failure is from the Emergency Department (ED) to a Stepdown Inpatient Unit. Based on two sentinel events in the community hospital , a quality improvement project was implemented to standardize the handoff tool used in the electronic health record, improve the nurse’s perception of the handoff process and decrease the time from ED bed assignment to arrival on the stepdown inpatient unit (SDIU). A lean process was used to analyze and evaluate the current process and implement the use of the electronic situation, background, assessment, and recommendation (eSBAR) tool. The findings were negligible with no improvement in the nurse’s perception of handoff, or time from the ED bed assignment to arrival on the SDIU. There were several gaps in utilizing the eSBAR tool, including each inpatient nurse, was required to add the handoff tool to their summary page manually. After completing the implementation of the project, the existing eSBAR needed further refinements, and several recommendations were made to the health care system.
The Effects of Dexmedetomidine on Airway-Related Complications During Emergence from General Anesthesia in Nasal and Paranasal Surgeries

Background: Stimulation of various sites, from the nasal mucosa to the diaphragm, can evoke laryngospasm. To reduce airway reflexes, tracheal extubation should be performed by special technique or with drugs that do not depress ventilation. However, tracheal extubation during rhinoplasty may be difficult because of the aspiration of blood and the possibility of laryngospasm. Dexmedetomidine has sedative and analgesic effects, without affecting respiratory status. Objectives: To evaluate the effects of dexmedetomidine on airway-related complications during emergence from general anesthesia (GA) in nasal and paranasal surgeries. Patients and Methods: This prospective randomized clinical study was included 90 patients of both sexes, admitted for elective nasal and paranasal sinus surgery. They were randomly allocated into three groups 30 patients each, Group A: Standard awake extubation technique. Group B: fully awake “no stimulation extubation” technique. Group C: Dexmedetomidine–group, who received intravenous (I.V) dexmedetomidine 0.5-1 μg/kg bolus in 100 ml of normal saline over 10 minutes before the end of surgery by 10 minutes, The dexmedetomidine bolus was followed by 0.2 μg/kg/hr which was stopped immediately when extubation was done. Results: The following parameters were assessed between the three groups: hemodynamics, airway-related complications, extubation time. Group C: was associated with a significant increase in extubation quality compared with group A and group B regarding hemodynamics, airway-related complications, extubation time. Conclusion: This study showed that the dexmedetomidine group associated with minimal circulatory reflexes and airway-related complications further to the advantage of short extubation time compared with the “no stimulation” extubation technique.
Highly active antiretroviral therapy and left ventricular diastolic function in children with human immunodeficiency virus infection

Background In the past, cardiovascular involvement did not seem to be a common complication of HIV, but in recent years it has been described more frequently. With the advent of highly active antiretroviral therapy (HAART), the symptoms of cardiac disease has changed, as the number of HIV-infected patients with abnormal diastolic parameters has increased significantly, often presenting as symptomatic rather than asymptomatic. Objective To analyze for a possible correlation between HAART duration and left ventricular diastolic function in HIV-infected children. Methods This cross-sectional study was conducted from December 2016 to December 2017 at the Cardiology and Allergy-Immunology Division/Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali. Subjects with HAART were collected using a consecutive sampling method. The following data were recorded for each subject: age, sex, current stage of HIV, CD4+ level, as well as HAART regimen and duration of use. Transthoracic echocardiography was performed for tissue doppler imaging (TDI) of diastolic function. Spearman’s test was used to analyze the strength of correlation based on normality test results. Results This study involved 53 subjects, 21 of whom had impaired diastolic function. There was no correlation between HAART duration and diastolic function in children with HIV infection (r= -0.03; P=0.82). Conclusion Diastolic dysfunction is found in children under HAART treatment, but there is no correlation between HAART treatment duration and diastolic dysfunction.
Mechanisms of auditory attention in normal and hearing impaired listeners

i Table of contents . vi List of figures . viii Abbreviations . x Acknowledgements . xi Candidate Contributions . xii Chapter 1. General Introduction . 1 1.1 The attentional filter: History . 3 1.2 The attentional filter: Cues . 5 1.3 The medial olivocochlear system: Proposed role . 7 1.4 The medial olivocochlear system: Anatomy . 8 1.5 The medial olivocochlear system: Physiology . 10 1.6 The medial olivocochlear system: Effects on hearing. 11 1.7 The medial olivocochlear system: In humans . 15 1.8 The medial olivocochlear system: Forming the attentional filter. 19 1.9 The medial olivocochlear system: Related structures . 25 1.10 Central mechanisms . 27 1.11 Structure and aims of the thesis . 28 Chapter 2. General Methods . 31 2.1 Acoustic Stimuli . 32 2.2 Psychophysical procedures. 33 2.3 Auditory thresholds . 34 2.4 Cued probe-target procedure to measure the attentional filter . 34 Chapter 3. Formation of the attentional filter in normal-hearing participants . 37 3.
Olfactory ensheathing cell transplantation improving cerebral infarction sequela: a case report and literature review

Stroke is the second leading cause of death and the main cause of long-term disability in the world. Therefore, treatment of the sequelae of stroke is one of the most important challenges in clinical neurotherapy. A 63-year-old Chinese woman with inarticulateness and right limb physical activity disorder for more than 4 months received olfactory ensheathing cells (OECs)-based neurorestorative therapy during the stay in hospital. Her neurological functions improved during 1-year follow-up. This case report showed that OECs therapy could be a treatment option for cerebral infarction sequela.
Development of Multiple-Lesion Basal Cell Carcinoma of the Skin: A Comprehensive Review

An interesting clinical feature of basal cell carcinoma (BCC) of the skin is a marked variation in tumor number, sites, and accrual. Some individuals develop only a single BCC lesion with no impact on health status, while a significant proportion is affected repeatedly with new primary tumors at various body sites. Approximately 29% of patients with a first BCC will develop at least 1 more lesion during their lifetime. The candidate predictors for multiple BCC development include younger age and a superficial BCC subtype at the time of the first diagnosis, red hair phenotype, initial or frequent tumor location on the trunk or on the upper limbs, and male gender. The pathogenesis of multiple BCC development does not seem to be related to greater UVR exposure. Individual genetic susceptibility may have a greater impact than extrinsic factors. In clinical practice, it is meaningful to estimate the probability of new BCC development in patients who have an initial lesion. A reliable prediction model for individualized risk stratification remains a subject of continued research; however, a focus on the risk factor profile is beneficial for clinical screening and may help clinicians to determine the individuals who should be followed up more closely.
Posterior Pericardial Window Technique to Prevent Postoperative Pericardial Effusion in Cardiac Surgery

YÖNTEM ve GEREÇLER: Koroner cerrahi geçirecek hastalar rastgele bir kontrole veya perikardiyal pencere tekniği grubuna ayrıldı. Toplamda 210 hastayı 2 gruba ayırdık, posterior perikardiyal pencere grubu (n = 110) ve kontrol grubu (n = 110). Preoperatif, intraoperatif ve postoperatif klinik veriler retrospektif olarak toplandı. Preoperatif, taburcu olmadan önce ve postoperatif 7. ve 30. günlerde yapılan değerlendirmelere elektrokardiyografi, göğüs radyografisi, ekokardiyografik incelemeler yapıldı. Postoperatif morbidite nedenleri ve yoğun bakım ünitesinde ve hastanede kalış süreleri kaydedildi.
Congenital elbow luxation in the dog.

: Four cases of bilateral and two cases of unilateral congenital elbow luxation in the dog were reviewed. In all cases, lameness was severe, osseous abnormalities were marked, and the dislocations primarily involved the humeroulnar articulation. Treatment consisted of closed reduction and external support in one dog and surgical reduction and stabilization in four dogs. One dog died before surgery could be performed. Treatment resulted in return of function to the affected limbs, even though osseous abnormalities and varying degrees of malarticulation persisted. Posttreatment observations, for as long as 4 years, demonstrated the persistence of near normal function of the limbs and minimal elbow deformity.
Learning Experiences Within Infectious Diseases Pharmacy Residency Programs in the United States: A Cross-Sectional Survey

Abstract Background Pharmacists with residency training in infectious diseases (ID) optimize antimicrobial therapy outcomes in patients and support antimicrobial stewardship (AS) programs. Although most ID residencies are accredited and assessed by certain standards, the degree to which these programs are similar is not known. Methods A 19-item, cross-sectional, multicentered, electronic survey was distributed via e-mail to pharmacy residency program directors (RPDs) of all 101 second-year postgraduate (PGY-2) ID residency programs in the United States. Results Survey responses were collected from 71 RPDs (70.3%); 64.8% were associated with an academic medical center and 97.2% focused primarily in adult ID. Rotations in the microbiology laboratory, adult AS, and adult ID consult were required in 98.6% of residency programs. Only 28.2% of responding programs required pediatric AS and pediatric ID consult rotations. Programs at academic medical centers were more likely to offer immunocompromised host ID consult (P = .003), pediatric ID consult (P = .006), and hospital epidemiology (P = .047) rotations but less frequently offered outpatient AS (P = .003), viral hepatitis clinics (P = .001), and travel medicine clinics (P = .007) rotations compared to programs at nonacademic medical centers. Residents were frequently involved in AS committees (97.2%), pharmacokinetic dosing of antimicrobials (83.1%), precepting pharmacy trainees (80.3%), and performing research projects (91.5%). Conclusions The PGY-2 ID pharmacy residency programs demonstrated consistency in required adult ID consult, antimicrobial management activities, committee service, and teaching and research opportunities. Pediatric experiences were less common. The PGY-2 ID residency programs prepare pharmacists to become antimicrobial stewards for adult patients.
Serum procalcitonin in pregnancy-associated sepsis: A case control study

Background. Procalcitonin (PCT) is an established marker for sepsis, particularly bacterial, but its use in diagnosing pregnancy-associated sepsis (PAS) is relatively unexplored. Objective. To investigate whether PCT could be used for the diagnosis of PAS in our study population, and what the appropriate values might be for the diagnosis. Methods. The study included 40 pregnant, post-abortal and postpartum women with PAS, identified using systemic inflammatory response syndrome criteria. Patients with hypertensive disorders, premature rupture of membranes, severe trauma, liver cirrhosis and lung or thyroid malignancies were excluded. Forty healthy term pregnant women with sterile urine cultures were taken as controls. PCT levels were obtained at admission and statistically compared between the groups. Severity and culture positivity in PAS were also assessed. Results. Severe PAS was present in 30 patients. Overall culture positivity was seen in 55% ( n =22) of subjects. Culture-positive patients had higher PCT levels (3.03 μg/L) compared with the culture-negative (1.77 μ/L), though this did not reach statistical significance ( p =0.235). Mean (standard deviation) PCT in PAS patients was 2.46 (0.56) μ/L, while in healthy controls it was 0.091 (0.019) μg/L. This difference was statistically significant ( p 0.125 μg/L is suggested as the critical level for PAS diagnosis in appropriate clinical settings. Additionally, mean PCT levels differed significantly in severe v. non-severe PAS.
Aseptic Meningitis Accompanied with Kikuchi-Fujimoto Disease

Disease Hye Jin Hwang, MD, Eun Young Cho, MD, Yoon Young Yi, MD, Jin Man Kim, PhD, Joon Won Kang, PhD Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea Department of Pathology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, Korea
Arginine Induced Metabolic Acidosis and Acute Kidney Injury

Over the last few years, with the growing date on the internet and social media, patients are moving toward the use of alternative medicine and supplements for various medical conditions. Unfortunately, awareness in terms of side eﬀ ects and proper dosing is not well known to users. In this case report we present a case were a nurse was using an over the counter supplement to treat her medical condition for years, yet when the desired results were not achieved she overdosed ending up with non-anion gap metabolic acidosis and acute kidney injury requiring admission to intensive care unit and treated with hydration and Sodium Bicarbonate drip.
Gadolinium deposition in the brain: current knowledge and recommendations

Gadolinium based contrast agents (GBCAs) have been widely used intravenously in MRI examinations and are considered relatively safe in patients with intact renal function. However, since 2014, repeated administrations of GBCAs have been associated to high MRI signal intensity in deep brain nuclei, on unenhanced T1-weighted images, a finding that has been attributed to gadolinium (Gd) parenchymal deposition. Deep brain nuclei Gd deposition is variable among different agents available for clinical practice and is considered greater with linear GBCAs compared to macrocyclic agents. The clinical significance of Gd brain retention has not been extensively studied and remains, to a great extent, undetermined. In this review article, the biochemical structure of GBCAs, the clinical and pathologic studies investigating morphological and histological changes after multiple intravenous Gd administration, the suggested pathogenetic mechanisms and the recent recommendations towards safe use of these agents are summarised.
Extraintestinal manifestations in paediatric-onset inflammatory bowel disease depending on disease location and activity

Aim of the study: The aim of the study was to determine the prevalence and types of extraintestinal manifestations (EIMs) in paediatric-onset inflammatory bowel diseases (IBD), i.e. Crohn’s disease (CD) and ulcerative colitis (UC), depending on disease activity and location, and to determine whether the presence of EIM is associated with a distinctive clinical course of IBD. Material and methods: The medical records of 287 children with IBD with or without EIMs were retrospectively analysed, especially regarding the following characteristics: age at diagnosis, clinical symptoms, nutritional status, the Paris Classification, and IBD activity. Results: The study population of 287 children comprised 147 patients with UC (mean age 12.9 years) and 140 patients with CD (mean age 14.1 years). EIMs were diagnosed in 60 patients (20.9%). The most frequent immune-related EIM in UC patients was primary sclerosing cholangitis (PSC); the collective proportion of PSC and PSC/autoimmune hepatitis (AIH) was 14.9%. Arthropathy was the most prevalent EIM in the subpopulation of CD participants (10%). Pancolitis was a risk factor for EIMs in the UC patients (E4/E0-3 OR 2.3, 95% CI 1.05–5.06, p = 0.037), and especially for PSC and AIH/PSC (OR 2.77, 95% CI 1.09–7.06, p = 0.032). Nevertheless, patients with EIMs presented with bloody diarrhoea less frequently (69% vs. 90%, p = 0.011). The CD EIM(+) and EIM(–) patients did not differ significantly regarding the symptoms at hospital admission. No correlation was revealed between disease location or behaviour and EIM occurrence. The impact of the presence of EIM on CD activity is inconclusive. Conclusions: EIMs are a significant issue in the population of children with IBD; they developed in 20.9% of our patients. Determination of the prevalence of these manifestations and related risk factors might raise awareness of the problem and facilitate diagnosis and therapy.
Treatment of chronic pain in oncology: cooperation between the oncologist and psychooncologist

The aim of this work is to present the problem of chronic pain in neoplastic disease as a situation requiring diagnosis and interdisciplinary treatment. The phenomenon of chronic pain, its types, and causes are discussed. A discussion was held on appropriate scales for measuring pain intensity. Pharmacotherapy and psychotherapy were primarily presented among the discussed treatment methods, and issues related to other methods of interactions related to the treatment of patients with chronic pain in the course of neoplastic disease were discussed. The key aspect of the article is to draw attention to the implementation of multi-specialist treatment of chronic pain, including personalised solutions and the accommodation of the most favourable form of therapy and the methods of its implementation.
Assessing Wellbeing in People Living with Dementia Using Reminiscence Music with a Mobile App (Memory Tracks): A Mixed Methods Cohort Study

The number of people living with dementia is growing, leading to increasing pressure upon care providers. The mechanisms to reduce symptoms of dementia can take many forms and have the aim of improving the wellbeing and quality of life of the person living with dementia and those who care for them. Besides the person who has dementia, the condition has a profound impact upon their loved ones and carers. One therapeutic approach is the use of music, an area recognised as having potential benefit, but requiring further research. The present paper reports upon a mixed methods cohort study that examines the use of a musical mobile app as a way to promote song-task association in people living with dementia. The study took place in care home environments in the UK. A total of fourteen participants (N = 14) were recruited. Quantitative measurements were taken on a daily basis prior to, and during, use of the mobile app over several weeks. Metrics came from the complete Self-Assessment Manikin scale (arousal, valence, and dominance), and a subset of three from the Quality of Life in Alzheimer's Disease questionnaire (physical health, memory, and life as a whole). Subsequently, semistructured interviews were conducted with staff at the care home to assess the impact of the app upon their role and the residents they care for. No significant differences were found in the combined quantitative measures for the ten (n = 10) sets of responses sufficient to be analysed. However, the qualitative results suggest that use of the mobile app produced positive changes in terms of behaviour, ability, and routine in the life of residents living with dementia. These findings contribute to the growing body of evidence-based research in the field of musical therapies for reducing symptoms of dementia and highlight elements where further study is warranted.