Miracle-dz/UniFAR-FTUs huggingface dataset:
The Impact of Multimedia Education on Uptake of Comprehensive Eye Examinations in Rural China: A Randomized, Controlled Trial

Abstract Purpose: To study the effect of multimedia education on acceptance of comprehensive eye examinations (CEEs), critical for detecting glaucoma and diabetic eye disease, among rural Chinese patients using a randomized, controlled design. Methods: Patients aged ≥40 years were recruited from 52 routine clinic sessions (26 intervention, 26 control) conducted at seven rural hospitals in Guangdong, China. Subjects answered demographic questionnaires, were tested on knowledge about CEEs and chronic eye disease, and were told the cost of examination (range US$0–8). At intervention sessions, subjects were cluster-randomized to view a 10-minute video on the value of CEEs and retested. Control subjects were not retested. Trial outcomes were acceptance of CEEs (primary outcome) and final knowledge scores (secondary outcome). Results: At baseline, >70% (p = 0.70) of both intervention (n = 241, 61.2 ± 12.3 years) and control (n = 218, 58.4 ± 11.7 years) subjects answered no knowledge questions correctly, but mean scores on the test (maximum 5 points) increased by 1.39 (standard deviation 0.12) points (p < 0.001) after viewing the video. Intervention (73.0%) and control (72.9%) subjects did not differ in acceptance of CEEs (p > 0.50). In mixed-effect logistic regression models, acceptance of CEEs was associated with availability of free CEEs (odds ratio 18.3, 95% confidence interval 1.32–253.0), but not group assignment or knowledge score. Acceptance was 97.5% (79/81) when free exams were offered. Conclusions: Education increased knowledge about but not acceptance of CEEs, which was generally high. Making CEEs free could further increase acceptance.
Statin Use and Incident Cataract Surgery: A Case-Control Study

ABSTRACT Purpose: To determine the association between statin use and incident cataract surgery. Methods: Using the resources of the Rochester Epidemiology Project, a retrospective population-based, case-control study was performed. Cases included 6024 county residents aged 50 years and older who had first-eye cataract surgery between 1 January 2004 and 31 December 2011. Controls included residents who had never had cataract surgery and were matched to cases by age, sex, and index date within 1 month of surgery. Statin medications continuously prescribed for at least 1 year before the surgery date (cases) or index date (controls) were examined. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models. Results: There were 2557 (42%) statin users among cases having cataract surgery compared to 2038 (34%) statin users among controls never having had cataract surgery (p < 0.0001). Incident cataract surgery was significantly associated with increased odds of statin use (OR 1.29, 95% CI 1.19–1.55) after adjusting for age, sex, diabetes, cardiovascular disease, cerebrovascular disease, peripheral vascular disease, renal disease, oral and inhaled steroid use, and selective serotonin reuptake inhibitor use. The association was consistent in both subgroups of women (OR 1.34, 95%CI 1.22–1.49) and men (OR 1.17, 95% CI 1.05–1.30). Conclusions: Incident cataract surgery was associated with increased odds of statin use, and underscores the possibility that increasing statin use could be contributing to rising rates of cataract surgery.
Interprofessional Collaboration and the Introduction of Nursing Guidelines at Best Practice Spotlight Organizations

Effective patient care requires interprofessional collaboration and decisions based on clinical guidelines. The goal of this study was to determine how interprofessional collaboration influences the introduction of nursing Best Practice Guidelines. This study was a secondary qualitative analysis of data obtained from interviews and reports from two selected sites (long term care and community health care) that demonstrated interprofessional collaboration during the introduction of nursing Best Practice Guidelines. Findings emphasized the importance of communication, the role of an interprofessional team, and the understanding of the roles of all involved in the introduction of discipline specific clinical guidelines. In addition, unregulated staff members were involved in leadership roles and their work was important in providing effective interprofessional collaborative care during the introduction of guidelines. Therefore, it is essential to appropriately involve all members of the interprofessional team, regardless of discipline or educational level, during the introduction of clinical guidelines. (Word count: 149, maximum word count: 150) INTERPROFESSIONAL COLLABORATION AND NURSING GUIDELINES iii
Soft Drink Vending Machines in Schools

Abstract This paper examines the availability of soft drinks in schools ("pouring rights contracts") and its effects on the growing nutritional problems of American youth. Of special concern is the prevalence of overweight youth, which has been increasing at alarming rates. There has been a direct relationship found between soft drink consumption and overweight in youth. Soft drinks account for as much as 20% to 24% of the calories consumed by youth. Higher rates of soft drink consumption are seen in youth from lower socioeconomic backgrounds. School administrators play a negative role in the health of students when they allow commercialism (advertising and selling of products to students) in their schools. Soft drink companies have been at the forefront of commercialism in schools. These "pouring rights contracts" have helped encourage student addictions to high-calorie soft drinks, while at the same time making school administrators accustomed to the financial gains. Yet, many school administrators do not perceive pouring rights contracts as jeopardizing the health of students. Banning the sale of soft drinks on school campuses must be a higher priority for those concerned about the health of youth.
THE WILMER APPEALING PREHENSOR

A new type prosthetic prehensor for children aged 4 – 9 has been designed, constructed and build in an attempt to improve the appearance of the split-hook prosthesis. The new prehensor is a mechanically operated voluntary opening device. All mechanical parts are within the frame, and covered by a polyurethane cosmetic cover, which can be made in almost any color desired. Clinical testing of the prehensor by 4 children with a total time of use of over 170 months, revealed the mechanism to be very robust and reliable. The colorful hook cover is highly appreciated by the children. Encouraged by this success, a second larger size has been made intended for children aged 7 - 14. This medium size prehensor is now in clinical use by 1 child for over 12 months. Again, the appearance of the hook is highly appreciated, and again, the mechanism proves to be very reliable.
Suspected adverse reactions to contrast media in Campania Region (Italy): results from 14 years of post-marketing surveillance

Objective: During the last years in Italy, contrast media (CM) use increased. An increase of monitoring activities on CM-induced adverse drug reaction (ADR) is necessary, also in our regional territory. The main aim of this study was to give a preliminary evaluation of all Spontaneous Reports of ADRs (SRA) attributed to CM sent to Campania Pharmacovigilance Regional Center (CRFVC) from 01 January 2001 to 31 October 2014. Research design and methods: For each SRA we evaluated: frequency and source, ADRs onset (time to event, seriousness and outcome), socio-demographic characteristics and risk factors of cases, the most reported CM (checking for pharmacodynamic and pharmacokinetic interactions). Results: A total of 111 SRA were sent to CRFVC; specialist in radiology was the main source of reports. Ninety-seven SRA (87.3%) were referable to hypersensitivity reactions. Thirty-four SRA (30.6%) reported serious ADRs. The most reported CM were iopamidol, gadobenic acid and gadoteric acid. We identified two SRA induced by pharmacokinetic and/or pharmacodynamic interactions. Conclusions: During 14 years of post-marketing surveillance, only few SRA concerning CM-induced ADRs were sent to CRFVC probably due to underreporting. We aim to improve monitoring activity on CM-induced ADRs especially in hospitals. Most reported ADR and CM were in line with current body of literature.
Adjacent segment disease after anterior cervical discectomy and fusion: Incidence and clinical outcomes of patients requiring anterior versus posterior repeat cervical fusion

Background: Adjacent segment disease (ASD) is a well-recognized long-term outcome in patients with degenerative disease of the spine. In this manuscript, we focus on the development in ASD in patients who have undergone a prior anterior cervical discectomy and fusion (ACDF). Methods: Patient data were collected via clinical notes and patient interviews. Patients were followed for an average of 92.4 ± 72.6 months after the index ACDF. Results: Of the 108 patients who underwent revision surgery due to symptomatic ASD, 77 patients underwent re-do ACDF, while 31 patients had posterior fusion surgery. Patients were more likely to be operated on posteriorly if they were older (P = 0.0115), male (P = 0.006), or had a higher number of cervical vertebral segments fused during the index ACDF (P = 0.013). These patients were statistically also more likely to exhibit myelopathic symptoms (P = 0.0053), and usually had worse neurologic function as assessed on the Nurick (P = 0.0005) and ASIA scales (P = 0.0020). Postoperatively, patients receiving anterior revision surgeries had higher rates of recurrent radiculopathy (P = 0.0425) and higher recurrence of ASD compared with patients fused posteriorly (P < 0.0001). Conclusions: Patients undergoing an anterior revision surgery for ASD after ACDF have higher rates of postoperative radiculopathy and redevelopment of ASD when compared with posteriorly approached patients. Patients receiving posterior revision surgery had higher intraoperative blood loss, hospitalizations, and postoperative complications such as wound infections and discharge to rehabilitation, but had a statistically lower chance of redevelopment of ASD requiring secondary revision surgery. This may be due to the fact that posterior revision surgeries involved more levels fused. This study provides one of the longest and most comprehensive follow-ups of this challenging patient population. Prospective studies comparing surgical approaches and techniques are needed to corroborate our findings.
Differentially expressed genes in early gestational chorionic villi after administration of mifepristone

To investigate the effect of mifepristone on gene expression of human chorionic villi in early pregnancy, nine women were recruited into a randomised controlled trial. All subjects were healthy women who had regular menstrual cycles and sought termination of pregnancy up to 40 days gestational age. In the test group, gestational sacs were taken by vacuum aspiration of the uterus 24 h after a single dose of 150 mg mifepristone was administered. Chorionic villi were collected and frozen in liquid nitrogen. The control samples were collected using the same method from the women without administration of mifepristone. The gene expressions of villus were monitored by human cDNA microarrays. It is found that the expressions of 262 transcripts were significantly altered in the test group. Gene ontology and pathways analyses were conducted to further analyse these genes. Many of these genes are known to play potentially an important role in the placentation and the molecular regulation of maternal–fetal interface. Therefore, it is suggested that the placental development and microenvironment of the maternal–fetal interface were interfered by administration of mifepristone. These data provide insight into the molecular mechanism about medical abortion induced by mifepristone.
Effects of teriparatide on lung function and pain relief in women with multiple osteoporotic vertebral compression fractures

Background: Osteoporosis is predominantly a condition of the elderly. In this study, we evaluated the effects of teriparatide on lung function and pain relief in elderly women with multiple osteoporotic vertebral compression fractures. Methods: A total of 37 patients who received teriparatide treatment during the period January 2010 to December 2011 were enrolled. Dual-energy X-ray absorptiometry scans were used to measure bone mineral density (BMD) and lung function was measured using a MasterScreen Body Jaeger spirometer. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) values were recorded. The Oswestry Disability Index (ODI) and the Visual Analog Scale (VAS) for pain were used to evaluate physical health and pain intensity, respectively, at baseline and after 6 months of teriparatide treatment. Results: Mean BMD at the lumbar spine increased from 0.716 g/cm2 at baseline to 0.829 g/cm2 after 6 months of treatment. In addition, both mean FVC and FEV1 values after 6 months of treatment were significantly higher than baseline values (99.01% and 100.06% vs. 87.62% and 90.62%, respectively). Teriparatide treatment also resulted in a significant reduction in self-reported pain intensity and a significant improvement in physical health as measured by VAS and ODI scores, respectively. Conclusions: In addition to increasing BMD, teriparatide treatment improves the lung function and results in diminished pain intensity in women with multiple osteoporotic vertebral compression fractures.
Vacuum-assisted closure of necrotic and infected cranial wound with loss of dura mater: A technical note

Background: Complex cranial wounds can be a problematic occurrence for surgeons. Vacuum-assisted closure devices have a wide variety of applications and have recently been used in neurosurgical cases involving complex cranial wounds. There is only one report regarding the use of a vacuum-assisted closure device with loss of dura mater. We report a complicated case of a necrotic cranial wound with loss of dura mater. Case Description: A 68-year-old female underwent an evacuation of a subdural hematoma. Postoperatively, the patient developed a wound infection that required removal of the bone flap. The wound developed a wedge-shaped necrosis of the scalp with exposure of brain tissue due to loss of dura mater from previous surgeries. She underwent debridement and excision of the necrotic tissue with placement of a synthetic dural graft (Durepair®, Medtronic, Inc.) and placement of a wound vac. The patient underwent a latissismus dorsi muscle flap reconstruction that subsequently failed. After the wound vac was replaced, the synthetic dural graft was replaced with a fascia lata graft and an anterolateral thigh free flap reconstruction. We describe the technical nuances of this complicated case, how the obstacles were handled, and the literature that discusses the utility. Conclusion: We describe a case of a complex cranial wound and technical nuances on how to utilize a wound-vac with loss of dura mater.
From DSME to DSMS: Developing Empowerment-Based Diabetes Self-Management Support

In Brief Diabetes education has changed a great deal in recent years. Diabetes self-management education (DSME) programs have become more patient-centered and theoretically based, and there is a greater emphasis on providing ongoing support to sustain the self-management gains made by patients as a result of education. Based on the frameworks of self-determination and autonomy support, empowerment has served as the philosophical basis for diabetes self-management education for more than 15 years. This article describes the evolution of empowerment-based programs from DSME to ongoing diabetes self-management support and provides practical strategies for educators to use in the development of these programs.
Radiosurgery for high-grade glioma

Background: For patients with newly diagnosed high-grade gliomas (HGG), the current standard-of-care treatment involves surgical resection, followed by concomitant temozolomide (TMZ) and external beam radiation therapy (XRT), and subsequent TMZ chemotherapy. For patients with recurrent HGG, there is no standard of care. Stereotactic radiosurgery (SRS) is used to deliver focused, relatively large doses of radiation to a small, precisely defined target. Treatment is usually delivered in a single fraction, but may be delivered in up to five fractions. The role of SRS in the management of patients with HGG is not well established. Methods: The PubMed database was searched with combinations of relevant MESH headings and limits. Case reports and/or small case series were excluded. Attention was focused on overall median survival as an objective measure, and data were examined separately for newly diagnosed and recurrent HGG. Results: With respect to newly diagnosed HGG, there is strong evidence that addition of an SRS boost prior to standard XRT provides no survival benefit. However, recent retrospective evidence suggests a possible survival benefit when SRS is performed after XRT. With respect to recurrent HGG, there is suggestion that SRS may confer a survival benefit but with potentially higher complication rates. Newer studies are investigating the combination of SRS with targeted molecular agents. Controlled prospective clinical trials using advanced imaging techniques are necessary for a complete assessment. Conclusions: SRS has the potential to provide a survival benefit for patients with HGG. Further research is clearly warranted to define its role in the management of newly diagnosed and recurrent HGG.
Well-Being in Canadian Seniors: Findings from the Canadian Study of Health and Aging*

RÉSUMÉ Bien que le vieillissement soit associé aux problèmes de santé et à l'invalidité, la plupart des aîné(e)s évaluent leur santé sur une note positive et considèrent le vieillissement comme une période positive d'évaluation de la vie, d'accroissement de la sagesse et de maturité. La nature plutôt paradoxale de ces résultats laisse entendre que le bien-être en fin de vie se présente sous différents aspects. S'inspirant de données d'un échantillonnage national, ce document décrit le bien-être de certains aîné(e)s canadien(ne)s, en utilisant l'échelle multidimentionnelle Ryff et il examine les effets de différents éléments demographiques, socio-économiques et de santé sur les niveaux de bien-être signalés. L'autonomie est une composante robuste du bien-être des aîné(e)s, qui résiste aux conditions physiques et sociales de l'âge avancé. Mais, au fur et à mesure que les aîné(e)s vieillissent, ils constatent une diminution du sens de leur vie et des occasions de croissance provenant en partie de facteurs socio-économiques. Une bonne santé et un état fonctionnel permettent aux aîné(e)s de conserver un sentiment de maîtrise de leur environnement. Abstract While aging is associated with increased health problems and disability, most seniors subjectively rate their health positively, and view aging as a positive period of life evaluation, increased wisdom and maturity. The somewhat paradoxical nature of these findings suggests that later life well-being is multidimensional and variable. Drawing on data from a nationally representative survey, this paper describes the subjective well-being of a sample of Canadian seniors, using the Ryff multidimensional measure of well-being, and investigates the effects of various demographic, health and socio-economic conditions on reported levels of well-being. Seniors’ well-being is robust in terms of the dimension of autonomy, which is resilient to the physical and social circumstances of later life. But, as seniors age, they experience declines in their sense of purpose in life and opportunities for personal growth, in part, due to socio-economic factors. Good health and functional status are important for seniors’ sense of mastery over their surrounding world.
Topical delivery for the treatment of psoriasis

Importance of the field: Psoriasis is one of the most common human skin diseases. Topical therapy forms the cornerstone in the management of mild-to-moderate psoriasis. Topical therapies are also used as adjunctive to systemic therapy in moderate and severe forms of the disease. Areas covered in this review: In this review, an overview of psoriasis pathogenesis, new topical medications for psoriasis, new targets and molecules, combination topical therapies and combination of topical and phototherapy is provided. Over the past decade several efficacious and acceptable treatment options have emerged from the age-old therapies. The development of sophisticated formulation options has led to an enhancement in the rate and extent of drug delivery across the skin, increasing therapeutic value and improving patient compliance. What the reader will gain: Readers will learn about monotherapy and combination topical products as well as new topical drug delivery technology to achieve optimal clinical outcomes. This review will highlight the need to generate more dermal pharmacokinetic data for better understanding of the impact of formulation change on skin pharmacokinetics to help design improved topical drug delivery systems. Take home message: New topical formulations have the potential to achieve better efficacy with improved safety profile.
The Mental Health Nursing Review: implications for community psychiatric nurses

The recent review of mental health nursing recommended that nurses refocus their attention on people with serious mental illness. There are some encouraging trends in the training of nurses in problem-oriented case management. However, mental health nursing needs to face various problems. These include the need for the large-scale retraining of nurses currently working in traditional psychiatric hospitals and difficulties in the new Project 2000 programmes. In addition, there is a clear lack of leadership in the profession, largely because of the recent emphasis on management rather than clinical and academic attributes. Finally, nursing needs people who care what happens to the seriously mentally ill.
Minimal stimulation protocol using letrozole versus microdose flare up GnRH agonist protocol in women with poor ovarian response undergoing ICSI

Background: To compare the IVF outcomes of letrozole/antagonist and microdose GnRH agonist flare up protocols in poor ovarian responders undergoing intracytoplasmic sperm injection. Materials and methods: A randomized controlled trial was performed in patients with one or more previous failed IVF cycles in which four or less oocytes were retrieved when the gonadotrophin starting dose was at least 300 IU/day. Sixty patients were randomized by computer-generated list to receive either letrozole/antagonist (mild stimulation) n = 30 or GnRH-a protocol (microdose flare) n = 30. Results: Both groups were similar with respect to background and hormonal characteristics (age, duration of infertility, BMI, FSH, LH and E2). The clinical pregnancy rate per cycle was similar in both groups (13.3 vs. 16.6%; OR = 0.769; 95% CI = 0.185, 3.198). The doses of used gonadotropins and the number of stimulation days were significantly lower in the letrozole/antagonist protocol. The peak E2 level on the day of hCG, the endometrial thickness, the retrieved oocytes, the number of fertilized oocytes, the number of transferred embryos and the cancellation rate were statistically similar in both groups. Conclusions: The letrozole/antagonist protocol is a cost-effective and patient-friendly protocol that may be used in poor ovarian responders for IVF/ICSI.