Miracle-dz/UniFAR-FTUs huggingface dataset:
Symmetry of cervical multifidus muscle in females with chronic non-specific neck pain and healthy by ultrasonography

Background and Aim: Multifidus muscle is one of the short and deep posterior Paraspinal muscles, which gives stability to the spine during various activities. Studies have shown that in people with neck pain, weakness and atrophy of neck muscles are major factors in the incidence of neck pain. Measurement of muscle’s dimensions by ultrasonography provides an opportunity to be able to objectively assess muscle atrophy or hypertrophy. This study aimed to assess symmetry of cervical multifidus muscle size in females with chronic non-specific neck pain and healthy by ultrasonography apparatus. Materials & Methods: Twenty five women with unilateral chronic nonspecific neck pain and 25 healthy women were participated in this study. All subjects were employed and more than 4 hours working with computers or paying office in a day. Imaging of the cervical multifidus muscles were done bilaterally in the level of the fourth vertebra. Anterior-Posterior Dimension(APD), Lateral Dimension(LD), Cross-Sectional Area (multiplied of two diameters(APD&LD)) and the Shape ratio (Lateral diameter divided by the Anterior-Posterior diameter(LD/APD)) of the muscle were measured and recorded. Results: Multifidus muscle size in patients group was smaller than the healthy group. In patients group, size of multifidus muscle in the painful side was smaller than the opposite side. Asymmetry of muscle size between the two sides, in the patient group was higher than the control group (P < 0.05). The ratio of smaller size to the larger size of the muscle, in the healthy group was higher than the ratio in the patient group (P < 0.05). Conclusion: In patients group, asymmetry of the muscle size between two sides, also smaller size of the muscle in the painful side, showed that muscle atrophy has happened in the involved side.
FROM THE THIRD GENEVA CONFERENCE ON PERSON-CENTERED MEDICINE: PERSON-CENTERED BASIC COMMUNICATION SKILLS Best Evidence Teaching of Person-centred Basic Communication Skills: a reflection

Adequate person-centred communication is an important cornerstone of good clinical practice and therefore requires training, just like other aspects of medicine do. The exact content of person-centeredness can vary depending on specific context and culture, but key issues mentioned frequently are: providing room for the patient’s story through involvement in consultations, with an emphasis on dialogue with the physician, exploring emotional cues and showing empathy, attention to the patient’s context, adjusting information and advice to that context and framing it in a positive way and involving patients in decisions on the management of illness. In practice, however, the concept of person-centeredness some-times works out differently from the one ‘on paper’. During the Third Geneva Conference on Person-Centered Medicine, a case history was used for discussion with the audience about patient centeredness. The focus was gradually shifted from the content of person-centeredness to the principles of teaching/training of communication skills. The participants contributed their opinions and these were supplemented with the available evidence from the literature leading to the reflection in this article.
Blood Sugar Lowering Effect of Pterocarpus santalinus (Red Sanders) Wood Extract in Different Rat Models

AbstractThe blood sugar lowering effect of a 95% ethanol extract of Red Sanders, Pterocarpus santalinus wood, was studied in fasted, fed, glucose-loaded and streptozotocin-diabetic models in albino rats. The material was found to be effective in lowering the glucose level.
Effects of Prodromal Stage and Untreated Psychosis on Subsequent Psychopathology of Schizophrenia: A Path Analysis

Background: To examine psychopathology present under prolonged antipsychotic treatment in schizophrenia and to analyse their relationship to both the duration of the prodromal stage (DPS; time between onset of first unspecific psychological symptoms and first schizophrenic symptoms) and the duration of untreated psychosis (DUP; time between the onset of psychosis and the initiation of antipsychotic treatment). Methods: The psychopathology of 93 patients was assessed cross-sectionally using the Scales for the Assessment of Negative and Positive Symptoms and the Brief Psychiatric Rating Scale. DPS and DUP were assessed by means of the patient records and the Interview for the Retrospective Assessment of the Onset and Course of Schizophrenia and Other Psychoses. A path analysis using maximum likelihood estimation was conducted with the program Analysis of Moment Structures for Windows. Results: The resulting path model indicated that DPS was predictive for a more severe negative symptomatology in schizophrenia, whereas DUP was associated with a more severe positive symptomatology in the long-term. Furthermore, DUP showed an inverse correlation with the age of the patients at the onset of both first unspecific psychological symptoms and first schizophrenic symptoms. Conclusion: A long prodromal stage suggests an increased risk of a long-term progression with negative symptoms in schizophrenia, whereas a delayed start of antipsychotic treatment could lead to an increased manifestation and severity of positive symptoms in the long term. These results underline the need to shorten the duration of the prodrome by an early detection and adequate intervention in patients with increased risk to develop psychosis.
Biotechnology and Bioengineering

Funding information National Institutes of Health, Grant/Award Numbers: 1F32EB026916, 1R21EB020192, 5P41EB002503, 5R01EB023812; Shriners Hospital for Children, Grant/Award Number: 84311 Abstract Oxygen is vital to the function of all tissues including the liver and lack of oxygen, that is, hypoxia can result in both acute and chronic injuries to the liver in vivo and ex vivo. Furthermore, a permanent oxygen gradient is naturally present along the liver sinusoid, which plays a role in the metabolic zonation and the pathophysiology of liver diseases. Accordingly, here, we introduce an in vitro microfluidic platform capable of actively creating a series of oxygen concentrations on a single continuous microtissue, ranging from normoxia to severe hypoxia. This range approximately captures both the physiologically relevant oxygen gradient generated from the portal vein to the central vein in the liver, and the severe hypoxia occurring in ischemia and liver diseases. Primary rat hepatocytes cultured in this microfluidic platform were exposed to an oxygen gradient of 0.3–6.9%. The establishment of an ascending hypoxia gradient in hepatocytes was confirmed in response to the decreasing oxygen supply. The hepatocyte viability in this platform decreased to approximately 80% along the hypoxia gradient. Simultaneously, a progressive increase in accumulation of reactive oxygen species and expression of hypoxia‐inducible factor 1α was observed with increasing hypoxia. These results demonstrate the induction of distinct metabolic and genetic responses in hepatocytes upon exposure to an oxygen (/hypoxia) gradient. This progressive hypoxia‐on‐a‐chip platform can be used to study the role of oxygen and hypoxia‐associated molecules in modeling healthy and injured liver tissues. Its use can be further expanded to the study of other hypoxic tissues such as tumors as well as the investigation of drug toxicity and efficacy under oxygen‐limited conditions.
Prophylactic nipple‐sparing mastectomy in young previvors: Examining decision‐making, reconstructive outcomes, and patient satisfaction in BRCA+ patients under 30

Bilateral prophylactic mastectomies (BPM) in young previvors with high‐risk mutations are rising; however, little data on management, therapy timing, and outcomes exist. BRCA+ patients under 30 undergoing BPM from 2006 to 2018 were reviewed. Twenty‐two patients aged 23‐29 underwent mastectomy 4.2 years after genetic diagnosis. Twelve patients completed surveys, most often citing personal decisions (50%) for undergoing mastectomy and plastic surgeons’ recommendations (83.3%) for reconstruction. About 73% of patients completely understood risks/benefits of mastectomy and 63.6% of reconstruction. Patients reported high BREAST‐Q Satisfaction and Well‐Being scores. Continued educational resource development will optimize shared decision‐making in the reconstructive process.
Playing Analog Games Is Associated With Reduced Declines in Cognitive Function: A 68-Year Longitudinal Cohort Study

Abstract Objectives Playing analog games may be associated with better cognitive function but, to date, these studies have not had extensive longitudinal follow-up. Our goal was to examine the association between playing games and change in cognitive function from age 11 to age 70, and from age 70 to 79. Method Participants were 1,091 nonclinical, independent, community-dwelling individuals all born in 1936 and residing in Scotland. General cognitive function was assessed at ages 11 and 70, and hierarchical domains were assessed at ages 70, 73, 76, and 79 using a comprehensive cognitive battery of 14 tests. Games playing behaviors were assessed at ages 70 and 76. All models controlled for early life cognitive function, education, social class, sex, activity levels, and health issues. All analyses were preregistered. Results Higher frequency of playing games was associated with higher cognitive function at age 70, controlling for age 11 cognitive function, and the majority of this association could not be explained by control variables. Playing more games was also associated with less general cognitive decline from age 70 to age 79, and in particularly, less decline in memory ability. Increased games playing between 70 and 76 was associated with less decline in cognitive speed. Discussion Playing games were associated with less relative cognitive decline from age 11 to age 70, and less cognitive decline from age 70 to 79. Controlling for age 11 cognitive function and other confounders, these findings suggest that playing more games is linked to reduced lifetime decline in cognitive function.
Examining Behaviors Related to Retirement, Cleaning, and Storage of Turnout Gear Among Rural Firefighters

Background: Although the increased occupational exposures among career firefighters are well documented, there are gaps in research related to exposures among volunteer firefighters. This study was completed in a state where the majority of firefighters are volunteers. We aimed to examine if differences existed in career versus volunteer firefighters’ behaviors related to the retirement, cleaning, and storage of turnout gear which may increase occupational exposures. Methods: A cross-sectional survey was administered to a convenience sample of 300 firefighters during a training event for both volunteer and career firefighters from one fire district in Kentucky. We measured factors that may affect behaviors related to retirement, cleaning, and storage of turnout gear, such as age of turnout gear at retirement, frequency of cleaning, and location of storage. Results: Two hundred and seventy-five firefighters out of 300 invited participants completed the survey, for a response rate of 92%. The majority of the participants were compliant with National Fire Protection Association Standards with most reporting cleaning their gear as needed, storing gear at the fire station, and retiring gear within 10 years of the manufactured date. Most of the participants (88%) were concerned about job-related exposures and felt susceptible to diseases like cancer and respiratory illness. The structural issues of cost and accessibility were identified as the primary barriers to the proper retirement and cleaning of turnout gear, especially among volunteer firefighters. Conclusions/Application to Practice: Most participants retired, cleaned, and stored turnout as recommended. The majority of participants were concerned with job-related exposures. The structural issues of cost and accessibility were identified as the primary barriers to the proper retirement and cleaning of turnout gear, especially among volunteer firefighters. By identifying differences, tailored trainings could be aimed at volunteer firefighters to help reduce their exposures.
Quality Awareness and Its Influence on the Evaluation of App Meta-Information by Physicians: Validation Study

Background Meta-information provided about health apps on app stores is often the only readily available source of quality-related information before installation. Objective The purpose of this study was to assess whether physicians deem a predefined set of quality principles as relevant for health apps; whether they are able to identify corresponding information in a given sample of app descriptions; and whether, and how, this facilitates their informed usage decisions. Methods All members of the German Society for Internal Medicine were invited by email to participate in an anonymous online survey over a 6-week period. Participants were randomly assigned one app description focusing on cardiology or pulmonology. In the survey, participants were asked three times about whether the assigned description sufficed for a usage decision: they were asked (1) after giving an appraisal of the relevance of nine predefined app quality principles, (2) after determining whether the descriptions covered the quality principles, and (3) after they assessed the availability of detailed quality information by means of 25 additional key questions. Tests for significance of changes in their decisions between assessments 1 and 2, and between assessments 2 and 3, were conducted with the McNemar-Bowker test of symmetry. The effect size represents the discordant proportion ratio sum as a quotient of the test statistics of the Bowker test and the number of observation units. The significance level was set to alpha=. 05 with a power of 1-beta=. 95. Results A total of 441 of 724 participants (60.9%) who started the survey fully completed the questionnaires and were included in the evaluation. The participants predominantly rated the specified nine quality principles as important for their decision (approximately 80%-99% of ratings). However, apart from the practicality criterion, information provided in the app descriptions was lacking for both groups (approximately 51%-92%). Reassessment of the apps led to more critical assessments among both groups. After having familiarized themselves with the nine quality principles, approximately one-third of the participants (group A: 63/220, 28.6%; group B: 62/221, 28.1%) came to more critical usage decisions in a statistically significant manner (McNemar-Bowker test, groups A and B: P<.001). After a subsequent reassessment with 25 key questions, critical appraisals further increased, although not in a statistically significant manner (McNemar-Bowker, group A: P=.13; group B: P=.05). Conclusions Sensitizing physicians to the topic of quality principles via questions about attitudes toward established quality principles, and letting them apply these principles to app descriptions, lead to more critical appraisals of the sufficiency of the information they provided. Even working with only nine generic criteria was sufficient to bring about the majority of decision changes. This may lay the foundation for aiding physicians in their app-related decision processes, without unduly taking up their valuable time.
Physiological mechanisms underlying children's circannual growth patterns and their contributions to the obesity epidemic in elementary school age children

Several studies since the 1990s have demonstrated that children increase their body mass index at a faster rate during summer months compared with the school year, leading some to conclude that the out‐of‐school summer environment is responsible. Other studies, however, have suggested that seasonality may play a role in children's height and weight changes across the year. This article reviews evidence for seasonal differences in the rate of children's height and weight gain and proposes potential physiological mechanisms that may explain these seasonal variations.
Diaphragm protection: what should we target?

PURPOSE OF REVIEW Diaphragm weakness can impact survival and increases comorbidities in ventilated patients. Mechanical ventilation is linked to diaphragm dysfunction through several mechanisms of injury, referred to as myotrauma. By monitoring diaphragm activity and titrating ventilator settings, the critical care clinician can have a direct impact on diaphragm injury. RECENT FINDINGS Both the absence of diaphragm activity and excessive inspiratory effort can result in diaphragm muscle weakness, and recent evidence demonstrates that a moderate level of diaphragm activity during mechanical ventilation improves ICU outcome. This supports the hypothesis that by avoiding ventilator overassistance and underassistance, the clinician can implement a diaphragm-protective ventilation strategy. Furthermore, eccentric diaphragm contractions and end-expiratory shortening could impact diaphragm strength as well. This review describes these potential targets for diaphragm protective ventilation. SUMMARY A ventilator strategy that results in appropriate levels of diaphragm activity has the potential to be diaphragm-protective and improve clinical outcome. Monitoring respiratory effort during mechanical ventilation is becoming increasingly important.
Diagnosis of acute intoxications in critically ill patients: focus on biomarkers – part 1: epidemiology, methodology and general overview

Abstract Acute intoxications account for a significant proportion of the patient population in intensive care units and sedative medications, ethanol, illicit drugs, inhalable poisons and mixed intoxications are the most common causes. The aim of this article is to describe biomarkers for screening and diagnosis of acute intoxications in critically ill patients. For this purpose, a survey of the relevant literature was conducted, and guidelines, case reports, expert assessments, and scientific publications were reviewed. In critical care, it should always be attempted to identify and quantify the poison or toxin with the assistance of enzyme immunoassay (EIA), chromatography, and mass spectrometry techniques and this section is critically appraised in this publication. The principles for anion gap, osmol gap and lactate gap and their usage in intoxications is shown. Basic rules in test methodology and pre-analytics are reviewed. Biomarkers in general are presented in part one and biomarkers for specific intoxications including ethanol, paracetamol, cardiovascular drugs and many others are presented in part two of these publications.
Synchronous multiple lung cancers presenting as multifocal pure ground glass nodules: are whole-body positron emission tomography/computed tomography and brain enhanced magnetic resonance imaging necessary?

Background Multifocal ground glass nodules (GGNs) represent a special radiological pattern indicative of synchronous multiple lung cancers (SMLCs), especially adenocarcinoma. However, the necessity of performing whole-body positron emission tomography/computed tomography (PET-CT) scanning and brain enhanced magnetic resonance imaging (MRI) as a staging workup for multifocal pure GGN (pGGN) patients remains unclear. The purpose of this study was to determine the utility of these two imaging scans for patients with multifocal pGGNs. Methods This retrospective study was reviewed and approved by the ethics committee of the Cancer Hospital of the Chinese Academy of Medical Sciences. The study cohort was retrospectively selected from patients with multifocal pGGNs who underwent whole-body PET-CT examinations and/or brain enhanced MRIs between January 2010 and February 2019 at our institution. The additional value of the two exams for detecting nodal and distant metastases was evaluated. Results In total, 73 patients (male-to-female ratio, 20:53; median age, 57 years) with multifocal pGGNs who underwent whole-body PET-CT (55 patients) and/or brain enhanced MRI (25 patients) were enrolled. No clearly metastatic lesions were detected. Among the enrolled patients, 53 (128 pGGNs) underwent complete surgical resection. All pGGNs were adenocarcinomas and/or preneoplasias, and no lymph node metastases were found on final pathology. Whole-body PET-CT and brain enhanced MRI added no definite benefit compared with chest CT alone before surgery. Conclusions Whole-body PET-CT scans and brain enhanced MRIs are not necessary for patients with multifocal pGGNs.
The three dimensions of caregiver grief in dementia caregiving: Validity and utility of the subscales of the Marwit‐Meuser Caregiver Grief Inventory

The experience of grief in family caregivers as they provide care for persons with dementia is often overlooked. The Marwit‐Meuser Caregiver Grief Inventory (MM‐CGI) is one among the few scales that capture such experiences. In a recent study, MM‐CGI was found to contain three subscales identifying dimensions of loss in caregivers—Personal‐Sacrifice Burden (PSB), Heartfelt Sadness, Longing, and Worry (HSLW), and Felt Isolation (FI). We aimed to evaluate the validity and utility of these dimensions in a multiethnic Asian population.
Neonatal resuscitation: knowledge and practice of nurses in western Nigeria

Background. Appropriate resuscitation techniques are crucial to the survival of newborn infants. Objective. To assess knowledge of nurses in western Nigeria about neonatal resuscitation. Method. A cross-sectional survey of the nurses attached to secondary health facilities in western Nigeria was done using a closed-ended questionnaire that tested evaluation and appropriate action aspects of neonatal resuscitation. Results. One hundred and seventy-nine nurses were interviewed. Of these, 72.6% had worked in the labour room and the special care baby unit within the last 5 years while only 14.0% had attended neonatal resuscitation training course within the last 5 years. Similarly, 31.8%, 53.1%, 58.1% and 35.2% had access to radiant warmers, ambu-bags, suction machine and oxygen delivery units, respectively. The knowledge of the respondents was better for evaluation than for appropriate action (95.5% v. 49.7%). Conclusion. The knowledge of the respondents about appropriate actions to be taken during neonatal resuscitation was poor. Frequent and intensive courses on neonatal resuscitation are highly desired. South African Journal of Child Health Vol. 2 (1) 2008: pp. 23-25
Accounting and auditing in municipal organisations

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