Miracle-dz/UniFAR-FTUs huggingface dataset:
Population Based Approaches to the Integration of Primary and Secondary Care

Health systems have become increasingly fragmented. Conditions such as diabetes, which require a multidisciplinary approach to care involving both the primary and secondary care sectors, have been particularly affected by the lack of coordination. In order to integrate care around the needs of the patient, a complex process is required to gain agreement on how care should be delivered. Using diabetes as a case study, and by applying the Delphi technique and access to the available evidence, we have shown that patients, doctors, nurses and allied health workers can agree upon the scope of care required for a given clinical scenario and with the criteria for referral between those with different skills. These agreements can form the basis of Care-maps, which in turn allow the definition of gaps in care, required educational materials, needed assessment pro forma, tools for enhancing communication between health workers, and training activities. Existing integrated care approaches in the United Kingdom and the United States, focusing on quality of care rather than resource, have been associated with improvements in health care delivery. Those working in primary care should consider this approach for stimulating enhancements in both clinical quality and efficiency.
Ecology and physiology of deepwater chondrichthyans off southeast Australia : mercury, stable isotope and lipid analysis

Analyse de speciation a montre que le mercure est present a plus de 91 % sous forme de MeHg, et meme avec des taux superieurs a 95 % chez les especes des environnements les plus profonds. Les concentrations maximales en THg ont ete trouves dans les tissus musculaires (59 a 82 % de charge corporelle). Les reins et le foie possedent aussi des taux eleves, respectivement de 0,3 a 4,2 et 0,5 a 1,5 mg kg-1 (ph), tandis que la peau enregistre les concentrations les plus faibles (> 0,3 mg kg-1, ph). Cette etude de l’organotropisme permet de conclure que les reins et le foie sont associes au metabolisme du metal, a l'elimination et au stockage a court terme, alors que le muscle est le sites le plus important du stockage du mercure a long terme. Les isotopes stables de carbone et d’azote ont ete utilises pour evaluer l'influence de la position trophique (d15N) et de la source de carbone (d13C) sur l'accumulation du THg chez les chondrichthiens. Le d15N varie entre 12,4 a 16,6 ‰ demontrant la large gamme de positions trophiques occupees par ces especes. La variation interspecifique du d13C est quant a elle minimale (–18,7 a –17,1 ‰). Les concentrations en mercure notees chez la plupart des requins augmentent en fonction de la taille, de la position trophique (d15N) et du stade de maturite de l’animal. Dans la communaute des chondrichthiens des profondeurs on observe des taux moderes de bioamplification du mercure, ceci est revele par la faible pente de la relation, log (THg mg kg-1 ww) = 0,2 (d15N) – 2,4 (R2 = 0,35 ; P <0,05). Le THg et les acides gras de 61 especes appartenant aux niveaux trophiques intermediaires ont ete analyses dans le but d’etudier les regimes alimentaires des proies et la bioaccumulation de ce metal a travers la chaine alimentaire demersale. L'utilisation integree de ces techniques biochimiques a fourni des donnees fondamentales sur la reproduction, l'accumulation en mercure et l'ecologie trophique des chondrichthiens des profondeurs. La comprehension de ces fonctions est imperative non seulement pour la mise en place d’une gestion durable des pecheries, mais aussi pour la protection des habitats des chondrichthiens et leurs ecosystemes associes.
Clinical characteristics of acute pulmonary embolism in 50 elderly patients

Objective To investigate the risk factors, the clinical assessment, and to develop a proper diagnostic strategy and clinical management for the elderly patients with pulmonary embolism. Methods The predisposing factors, clinical assessment, treatment and outcomes of 50 consecutive elderly patients with established acute pulmonary embolism were analyzed retrospectively. Results 92% had dyspnea, 56% had cough, 50% had palpitation, 46% had chest pain, 94% had hypoxemia, 90% had D-Dimer500 ng/ml. Spiral-CT pulmonary arteriography(CTPA) was the main diagnostic method. Nineteen patients received thrombolytic therapy, Twenty-nine patients received anticoagulative therapy, 2 patients didn't receive any therapy because of bleeding. Five(10%) patients were cured, 43 (86%) patients got better, 2(4%) patients were dead. Conclusions The clinical manifestations of pulmonary embolism in the elderly were varied. CTPA is the main diagnostic method and ventilation-perfusion lung scan or pulmonary angiography can be done when it is necessary. Thrombolytic treatment can improve the survival rate of patients with acute pulmonary embolism.
The preventive effect of Acarbose and Metformin on the IGT population from becoming diabetes mellitus: a 3-year multicentral prospective study

Objective To assess the effect of pharmacological and non pharmacological interventions on Chinese subjects with impaired glucose tolerance (IGT). Methods In this 3 year prospective study, 321 subjects aged above 25 years with IGT were included. IGT was defined by 1985 WHO criteria utilizing a 75 g oral glucose tolerance test (OGTT). The subjects were divided into control (C), diet plus exercise (D+E), Acarbose (Glucobay, A) and Metformin (M) groups. The subjects in the group D+E underwent an individually designed diet and exercise program, the importance of which was reiterated annually. The group C only received conventional education on diabetes prevention. The two pharmacological groups were orally given Acarbose (50 mg, t.i.d) and Metformin (0.25 g, t.i.d) respectively. OGTT, weight, height, blood pressure, lipids were measured yearly during the follow up. The t test, Chi square test and proportional hazard regression analysis were used to analyze the risk reduction in diabetes conversion from each group. Results The baseline data of 4 groups had no statistical differences. By the end of study, both the fasting plasma glucose (FPG) and the 2h postprandial plasma glucose (2hPG) in group C elevated (FPG from 6.02 mmol/L to 6.59 mmol/L, 2hPG from 8.83 mmol/L to 9.13 mmol/L), and the annual diabetes incidence was 11.6%. The corresponding changes in group D+E were FPG from 6.11 mmol/L to 6.21 mmol/L, PG2h from 9.28 mmol/L to 8.98 mmol/L, and 8.2% of annual diabetes incidence. In contrast, both the FPGandthe2hPG significantly decreased in group A (FPG from 6.03 mmol/L to 5.47 mmol/L, 2hPG from 8.34 mmol/L to 7.21 mmol/L)andingroup M (FPG from 6.01 mmol/L to 5.85 mmol/L, 2hPG from 9.05 mmol/L to 7.92 mmol/L). Theannualdiabetesincidencedecreasedto2.0% in group A, and 4.1% in group M. Proportional hazard regression analysis showd that the annual diabetes incidence was positively correlated with the baseline 2hPG and body mass index (OR=1.33, P=0.006 and OR=1.11, P=0.008, respectively), and negatively correlated with group C and group M (OR=0.12, P=0.0001 and OR=0.23, P=0.0002, respectively). Conclusion Thenaturaldiabetesincidenceis 11.6% in IGT population, and 8.2% in population with conventional diet and exercise interventions, between them there is no significant difference. The pharmacological interventions with Acarbose or Metformin significantly decrease diabetes incidence of IGT population.
Gentamicin-coated Tibia Nails: Can We Afford NOT to Use Them?

The operative treatment of fractures has made enormous progress over the last decades. Nevertheless, fracture treatment remains a challenge for surgeons, and in particular, the more complicated fractures still harbor the potential for complications that cannot be underestimated. To improve prophylaxis against bacterial colonization of the implant surface, local delivery of antibacterial substances is an effective and promising option. In recent years, a fully resorbable coating for intramedullary nails was developed for the delivery of active substances such as antibiotics to the implantation site. This coating leads to antibiotic concentrations well above the minimal inhibitory concentration of the most commonly encountered bacterial strains in the immediate surroundings of the implant. On the basis of promising data from animal studies, an intramedullary tibial nail with antibiotic coating was developed and approved for clinical use in European countries. The first such implant (UTN PROtect) was released in 2005 and subsequently investigated in a prospective case series, where it proved to be an useful tool in the treatment of tibial fractures in patients presenting a higher risk of developing implant-related infections. Since 2011, a tibial nail of the latest generation design with the same coating is available (Expert Tibial Nail PROtect) and is being used on a broader scale.
The intervention of Semen Strychni on the inflammatory factors in the serum of AA rats

Objective To explore the intervention of Semen Strychni on the inflammatory factors in the serum of AA rats. Methods Determination of rat paw swelling degree after d 17, d 21 and d 24.Determination of serum IL-10, IL-23 levels in 25 days after the proinflammatory. Results Semen Strychni can significantly inhibit the rat paw swelling, can significantly improve the anti-inflammatory cytokine IL-10 levels in the serum of AA rats, and lower IL-23 content. Conclusion The traditional Chinese medicine Semen Strychni have an effect of anti-AA.
Abstract S2-6: Aromatase Inhibitors and Risk of Myocardial Infarction, Stroke and Fracture

Randomized trials have demonstrated that aromatase inhibitors (AI9s) are more effective than tamoxifen in preventing breast cancer recurrence. Since many women with early stage disease have a modest risk of recurrence, it is important to consider carefully the potential side effects of treatments in this setting. Trials have suggested increased risk of fracture is the only serious side effect of AI9s, but study participants are often healthier than the general population, and little is known about toxicities of AI9s in nontrial populations. We sought to evaluate the association between use of AI9s and the incidence of myocardial infarction (MI), stroke, and fracture in community-based populations. Methods: Using encounter and pharmacy data from WellPoint plans in the HealthCore Integrated Research Database, 44,463 women aged ≥50 years with at least 2 diagnosis codes for breast cancer between 2001 and 2007 were identified and followed through the end of 2008. We used propensity score methods to identify matched controls from a cohort of 88,101 women aged ≥50 years enrolled in WellPoint plans who had no diagnosis codes for breast cancer. We identified receipt of aromatase inhibitors and tamoxifen and used Cox proportional hazards models with time-varying treatment variables to assess whether treatment with aromatase inhibitors or tamoxifen was associated with MI, stroke, and fracture among women with breast cancer and to assess the association of breast cancer with the outcomes of interest. Results: Among 44,049 breast cancer patients and 44,049 matched controls, the average age was 67 and 87% of cases and controls had no baseline comorbidities. After a median follow-up of 899 days for cases and 1004 for controls, 1.3% of women had an MI, 2.9% an ischemic stroke, 1.5% a hip fracture and 9.5% any fracture. Breast cancer patients treated with AI9s had a significantly lower adjusted hazard of ischemic stroke and a significantly higher adjusted hazard of fracture compared with breast cancer patients not receiving an AI or tamoxifen. Table. Adjusted hazard ratio (95% CI) associated with breast cancer and hormonal therapy Treatment with AI or tamoxifen was not associated with MI or any fracture. Patients treated with tamoxifen had a significantly lower adjusted hazard of stroke and hip fracture compared with breast cancer patients not receiving hormonal therapy. Conclusion: The side effect profile of AI9s in this community-based population was similar to that seen in clinical trials and suggests that these drugs are associated with few serious side effects. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S2-6.
Characterization of patients with surgical iatrogenic injuries of the biliary apparatus

A descriptive study of 35 surgically treated patients by means of conventional and laparoscopic techniques who presented iatrogenic injuries of the biliary system, was carried out in the General Surgery Service of “Saturnino Lora Torres” Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, in a 8 year period (2007-2014), with the aim of characterizing them according to some variables of interest and of determining the associated mortality. Among the predominant results there were the female sex and the ages from 35 to 54 years, the produced lesions of the elective videolaparoscopic cholecystectomy for vesicular lithiasis, the clinical forms of presentation the intraabdominal abscess with peritonitis signs and jaundice, diagnosis confirmed by means of the echography. Also, injuries A and C, according to the classification of Strasberg, were those most reiterated and the most common restorative technical procedure was drainage and washing of the abdominal cavity; 88.6% of the patients were discharged alive and 4 female patients died (11.4%) whose cause of death was the septic shock. It could be concluded that the moment of diagnosis for these lesions took place late, and that in spite of the complexity of the surgical repair, there was low mortality.
Critérios clínicos e biológicos para a remoção de tecido cariado Clinical and biological criteria for carious tissue removal

Carious dentin removal is a very important procedure during restorative treatment. However, the criteria used are still not well defined. To guide the professionals regarding this aspect, several me- thods and technical resources were suggested like, for example, the using of consistency or coloration as clinical parameters, besides the using of carious tissue dye. The use of these parameters, however, has showed to be ineffective for the identification of the tissue which needs to be removed. Among the biological aspects considered du- ring carious tissue removal, the maintenance of deeper portions of carious cavity and its subse- quent sealing, avoiding the lesion progression has been suggested. Nevertheless, the limits of this preservation are still not well stablished. Key words: dental caries, resto- rative treatment, carious dentin, cavity preparation.
of Intramuscular Lidocaine in the Prehospital Setting for Ventricular Tachyarrhythmias Unassociated With Acute Myocardial Infarction Vh e "Shahal"*Experience in Israel)

We report on the experience accumulated by the sub- ical team to the patient was estimated to be at least 8 scribers of SHAHAL cardiac services who self-injected to10 minutes. Successful usage of the LidoPen was reintramuscular lidocaine (using an automatic injector ported in 137 cases (123 patients). An additional 11 “LidoPen”) for documented ventricular tachyarrhyth- patients failed to use the injector properly. There was a mias which were not associated with an acute myocar- success rate in abolishing rapid sustained ventricular dial infarction. SHAHAL provides professional care to its tachycardia (27 of 76 patients) and nonsustained vensubscribers who telephone a monitor center and de- tricular tachycardia and/or multiple and complex venscribe their symptoms, whereupon therapeutic measures tricular ectopic activity (8 of 30 patients) of 33% (total are decided upon. Patient data are stored in a central 35 of 106 patients). In another 9%, those arrhythmias computer, and the center can dispatch mobile intensive were slowed markedly. The remaining 31 cases were care units. All subscribers carry a portable transtele- eventually interpreted as being of supraventricular oriphonic electrocardiographic transmitter and are pro- gin. No complications attributed to the use of the injector vided with the LidoPen. Indications for self-injection were reported and its use was found to be both feasible were: transmission of a wide-QRS tachycardia (rate and effective in the prehospital setting. o 7 997
Treatment of war injuries of the upper extremity during war in south-western Croatia

Objectives: The aim of this study was to analyze the epidemiology, treatment and incidence of complications among the patients with upper extremity war injury. Methods: In retrospective study, 123 patients with war injuries of the upper extremity have been analyzed. The results of treatment were assessed according to the rate of: complications, amputations, fracture healing and mortality. Results: Complications appeared in 17.9% of cases. Traumatic amputations were present in 19.4% of cases and in 2.4% of cases amputation was performed due to III C open fracture. Satisfactory bone healing was achieved in 49 of 55 patients available to follow up. Mortality rate was 2.4%. Conclusion: Self-inflicted injuries resulted in 41.6% amputation rate. High-energy war injuries of the upper extremity could be treated between 6 and 12 hours after injury without an increase in complication rate, compared to treatment up to 6 hours from injury. In selected cases primary reconstruction of war injury could be performed.
Adoption of Electronic Health Records (EHRs): A Review of Technology Acceptance Studies

Over the last decade developed countries have invested considerable funds in health-related information technology research. Electronic health records (EHRs) represent an important innovation in healthcare information technology. EHRs can facilitate the process of patient management and care, and significantly reduce operational costs in healthcare settings. Healthcare professionals play a critical role in the success of EHRs but many of them are reluctant to adopt EHRs in their daily practice. The present paper reviews research derived from the Technology Acceptance Model (Davis, 1989), a behavioural model of acceptance and utilization of technological innovations in professional settings, including healthcare services. Following a systematic search and review of the literature, the empirical studies published between 1990 and 2012 are presented, and a synthesis of their main findings and implications for EHRs acceptance by healthcare professionals are discussed.
Resuscitating Acupuncture Effects on mRNA Expression of IL-1RI and TNFR-I in Brain Tissues of Rat with Cerebral Ischemia Reperfusion

OBJECTIVE To research the cellular and molecular mechanisms of resuscitating acupuncture against inflammatory reaction in brain after cerebral ischemia reperfusion.METHODS Acupuncture method of XNKQ(activating brain and opening orifices) were applied as therapeutic method,and the rat model of acute focal cerebral ischemia reperfusion as research object.The technology of RT-PCR was used to observe the mRNA expression of two key inflammatory cytokine receptors(IL-1RI and TNFR-Ⅰ) in different times after cerebral ischemia reperfusion.The regulatory law of acupuncture on the above indexes was also observed.RESULTS XNKQ acupuncture reduced the mRNA expression of IL-1RI and TNFR-Ⅰ in brain tissues of rats with cerebral ischemia reperfusion.The role of acupuncture was more obvious as the time past.CONCLUSION The acupuncture method of XNKQ could interfere inflammatory response in brain after cerebral ischemia reperfusion,and thus plays a protective role against brain injury.
Systematic Review of Acupuncture for Treatment of Post-stroke Shoulder Pain

Objective To evaluate the effectiveness of acupuncture therapy on post-stroke shoulder pain.Methods The review assessed the methodological quality of all eligible randomized or quasi-randomized trials of acupuncture for the treatment of post-stroke shoulder pain that identified by computerized and hand searches of the literature.The data was analysed by Review Manager software program.Results The evidence from randomised controlled trials so far confirmed that acupuncture therapy was effective in treating shoulder pain after stroke and benefited for limb motor recovery.But the quality of involved literature was low.Conclusion Acupuncture is effective in treating post-stroke shoulder pain,but the possibity of selectionbias and measurement bias reduced the reliability of conclusion.
BIOCHEMICAL ACTIONS OF A NOVEL CIS-TERPENONE

BIOCHEMICAL ACTIONS OF A NOVEL CIS-TERPENONE By Lin Zhang, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2012 Director: Qibing Zhou, Ph.D Assistant Professor Department of Chemistry Quinone methides are reactive species due to their electrophilicity, and natural quinone methide analogs have broad biological activities. Based on known actions of cytochrome P450 enzymes, we hypothesized that trans-terpenones can be metabolized in cells to form a cascade of metabolite products, which may be biologically active due to the generation of quinine and quinone methide reactive intermediates. Therefore, 3hydroxy-cis-terpenone (HCT) and analogs were designed and synthesized in our lab to investigate this hypothesis. As a first step in testing this hypothesis, we examined effects of cis-terpenones on the viability of HepG2 cells exposed to aflatoxin B1 (AFB1). Cis-terpenones combined
The study of prevalence of hypercholesterolemia of east Macedonia - risk and prevention

Introduction: Hypercholesterolemia is a condition characterized by very high levels of cholesterol in the blood. Inherited forms of hypercholesterolemia can also cause health problems related to the buildup of excess cholesterol in other tissues In this research are used the results of biochemical analyses and laboratory testing of cholesterol from private health diagnostic laboratory in east Macedonia of two years (2010-2011). The purpose of this researche is to show the prevalence and the risk of appearance of possible hypercholesterolemia defined by gender and age. Results and discussion: According to the analyzed results, we have concluded that in the male population most of the patients with higher concentration of cholesterol are in the age group between 40 and 60, but in the female population most cases of elevated higher concentration of cholesterol are in the age group over 60. It has been established a generation link i.e. elevated concentration of cholesterol appearing in two generations in one family. Conclusion: Hypercholesterolemia is a disease which is primary importance is to be detected and treated accordingly in its early stages with clinical laboratory methods and criteria, and molecular diagnostic methods for detection of the gentic reason for the appearance of this disease and appropriate treatment for patients and extention of their life span. Key words: Hypercholesterolemia, LDL-cholesterol, total cholesterol, FH, Cardiovascular disease, Molecular biological methods