Miracle-dz/UniFAR-FTUs huggingface dataset:
Therapy-based rehabilitation services for patients living at home more than one year after stroke.

BACKGROUND Current practice of rehabilitation intervention mainly concentrates on the first six months of stroke. At present, there is no agreed consensus about the benefits of such a service more than one year after stroke. OBJECTIVES To ascertain whether therapy-based rehabilitation services can influence outcome one year or more after stroke. SEARCH STRATEGY We searched the trials registers of the following Cochrane Review Groups: Stroke Group (last searched September 2007), Effective Practice and Organisation of Care Group (last searched October 2006) and Dementia and Cognitive Improvement Group (last searched October 2006). We also searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2006), MEDLINE (1966 to October 2006), EMBASE (1980 to October 2006), CINAHL (1982 to October 2006), AMED (1985 to October 2006), PEDro (1952 to October 2006), British Nursing Index (1993 to October 2006), DARE (1994 to October 2006), HMIC (1979 to October 2006) and NHS EED (1991 to October 2006). We also searched dissertation databases and ongoing trials and research registers, scanned reference lists and contacted researchers and experts in the field. SELECTION CRITERIA All randomised controlled trials of community-based stroke patients, in which at least 75% were recruited one year after stroke and received a therapy-based rehabilitation intervention that was compared with conventional care. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials and extracted data on a number of pre-specified outcomes. The primary outcomes were the proportion of participants who had deteriorated or were dependent in personal activities of daily living at the end of scheduled follow up. MAIN RESULTS We identified five trials of 487 participants that were eligible for the review. Overall, there was inconclusive evidence as to whether therapy-based rehabilitation intervention one year after stroke was able to influence any relevant patient or carer outcome. Trials varied in design, type of interventions provided, quality, and outcomes assessed. AUTHORS' CONCLUSIONS This review highlights the dearth of evidence investigating long-term therapy-based rehabilitation interventions for patients with stroke.
Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults.

BACKGROUND Chronic musculoskeletal pain (CMP) is a major health problem, accounting for approximately one-quarter of general practice (GP) consultations in the United Kingdom (UK). Exercise and physical activity is beneficial for the most common types of CMP, such as back and knee pain. However, poor adherence to exercise and physical activity may limit long-term effectiveness. OBJECTIVES To assess the effects of interventions to improve adherence to exercise and physical activity for people with chronic musculoskeletal pain. SEARCH STRATEGY We searched the trials registers of relevant Cochrane Review Groups. In addition, we searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, Science Citation Index and Social Science Citation Index and reference lists of articles to October 2007. We consulted experts for unpublished trials. SELECTION CRITERIA Randomised or quasi-randomised trials evaluating interventions that aimed to improve adherence to exercise and physical activity in adults with pain for three months and over in the axial skeleton or large peripheral joints. DATA COLLECTION AND ANALYSIS Two of the four authors independently assessed the quality of each included trial and extracted data. We contacted study authors for missing information. MAIN RESULTS We included 42 trials with 8243 participants, mainly with osteoarthritis and spinal pain. Methods used for improving and measuring adherence in the included trials were inconsistent. Two of the 17 trials that compared different types of exercise showed positive effects, suggesting that the type of exercise is not an important factor in improving exercise adherence. Six trials studied different methods of delivering exercise, such as supervising exercise sessions, refresher sessions and audio or videotapes of the exercises to take home. Of these, five trials found interventions improved exercise adherence. Four trials evaluated specific interventions targeting exercise adherence; three of these showed a positive effect on exercise adherence. In eight trials studying self-management programmes, six improved adherence measures. One trial found graded activity was more effective than usual care for improving exercise adherence. Cognitive behavioural therapy was effective in a trial in people with whiplash-associated disorder, but not in trials of people with other CMP. In the trials that showed a positive effect on adherence, association between clinical outcomes and exercise adherence was conflicting. AUTHORS' CONCLUSIONS Interventions such as supervised or individualised exercise therapy and self-management techniques may enhance exercise adherence. However, high-quality, randomised trials with long-term follow up that explicitly address adherence to exercises and physical activity are needed. A standard validated measure of exercise adherence should be used consistently in future studies.
Prevalencia y factores asociados a la rinitis alérgica en escolares de ciudad Guzmán, México

Introduccion: Una gran cantidad de factores de riesgo han sido propuestos para explicar el incremento en la frecuencia de rinitis alergica, entre ellos la atopia, el tabaquismo en los padres, el peso y tipo de alimentacion al momento de nacer, el estado nutricio, pero los resultados han sido inconsistentes. El presente estudio investiga el papel que juegan estos factores de riesgo en el desarrollo de rinitis alergica en una muestra de ninos escolares. Material y metodos: Los datos fueron obtenidos de ninos escolares de seis a 12 anos de edad. Los padres de los ninos completaron el cuestionario validado por el International Study on Asthma and Allergies in Childhood, se interrogo ademas acerca de antecedentes de atopia familiar, alimentacion al seno materno, peso al nacer y la via de nacimiento; peso y talla fueron considerados para calcular el indice de masa corporal. Resultados: De 740 ninos incluidos en el estudio, la frecuencia de rinitis alergica fue 5.5%; el antecedente de enfermedad alergica en el padre (OR = 3.1; IC95% 1.2 a 8.1, p = 0.018) o en la madre (OR = 3.2; IC95% 1.5 a 6.6, p = 0.002) estuvieron asociados importantemente al desarrollo de rinitis alergica. No encontramos asociacion con el resto de variables estudiadas. Conclusion: Estos resultados indican que la prevalencia de rinitis alergica es similar a la reportada en estudios previos. El unico factor de riesgo asociado a la rinitis alergica fue el antecedente en los padres de enfermedad atopica.
Road tra ffi c crash risk associated with prescription of hydroxyzine and other sedating H 1-antihistamines : A responsibility and case-crossover study

Background: H1 antihistamines differ from each other by their ability to cross the blood-brain barrier. The resulting sedating effect can be sought in therapy but may be a driving hazard. The aim of this study was to estimate the impact of sedating H1-antihistamines on the risk of road traffic crash, with a particular focus on hydroxyzine which is also indicated as an anxiolytic in France. Methods: The study consisted in extracting and matching data from three French nationwide databases: the national healthcare insurance database, police reports and the police national database of injurious crashes. All sedating H1-antihistamines, including hydroxyzine, were considered in the study. A case-control analysis, in which responsible drivers were cases and non-responsible were controls was performed. A case-crossover analysis, comparing for the same subject exposure during a period immediately before the crash with exposure during an earlier period, was also conducted. Results: The extraction and matching procedures over the July 2005-December 2011 period led to the inclusion of 142,771 drivers involved in an injurious road traffic crash. The responsibility study found an increased risk of being responsible for an injurious road traffic crash in hydroxyzine users who were registered with a long-term chronic disease (mostly psychiatric disorders) on the day of the crash (OR = 1.67 [1.22–2.30]). Among them, the risk was even higher in drivers with highest exposure levels (OR = 2.60 [1.23–5.50]). There was no impact of sedating H1 antihistamine treatment initiation on the risk of crash. Conclusion: Even if it is difficult to disentangle the part of the increased risk that would be causally related to hydroxyzine and the part related to behaviours of patients with a heavy psychiatric disorder, our study raises the alarm on the crash risk linked to hydroxyzine utilization in countries in which the anxiolytic indication is widespread.
Accuracy of working length measurement: electronic apex locator versus cone-beam computed tomography.

AIM To compare the accuracy of working length (WL) determination using the Raypex 6(®) electronic apex locator and cone-beam computed tomography (CBCT). METHODOLOGY A total of 150 extracted human teeth were decoronated and randomly assigned to five groups (n = 30). WL was measured with the Raypex 6(®) at both the 'constriction' and the 'apex' marks under dry conditions (group 1) or with 2.5% NaOCl, distilled water or Ultracain(®) (groups 2-4). The radiological WL (group 5) was calculated from bucco-lingual and mesio-distal CBCT sections. Differences between electronic, CBCT measurements and actual length (AL) were calculated. Positive and negative values, respectively, indicate measurements falling short or long of AL. Two-way anova and the Bonferroni and Welch tests were used to compare mean differences amongst groups. The chi-squared and Fisher's exact tests were used to compare percentages of precise, ±0.5 and ±1.0 mm of the AL measurements amongst the experimental groups. Statistical analysis was performed at α = 0.05. RESULTS Mean differences with respect to AL ranged from 0.26 to -0.36 mm and from 0.05 to 0.18 mm, respectively, for the electronic measurements at the 'constriction' mark and 'apex' mark. CBCT measurements were an average of 0.59 mm shorter than AL. Percentages of electronic measurements falling within ±0.5 mm of the corresponding AL referred to the 'apex' mark were greater than at the 'constriction' mark, but the differences were only significant in group 4 (with Ultracain(®) ). Percentages of CBCT measurements falling within ±0.5 mm of AL (46.7%) were significantly lower than electronic measurements, regardless of the condition of the root canal. In 30-38.5% of the measurements taken at the 'apex' mark and in 3.4-13.3% of those at the 'constriction' mark, the file tip extended beyond the foramen. CONCLUSIONS Electronic measurements were more reliable than CBCT scans for WL determination. The Raypex 6(®) was more accurate in locating the major foramen than the apical constriction under the experimental set-up.
Nutritional and Health Beneﬁts of Inulin and Oligofructose Fiber, Inulin and Oligofructose: Similarities and Differences 1

The biological, chemical and physical properties of dietary ﬁbers are associated with physiologic actions in the small and large intestine that have important metabolic implications for health. These properties of ﬁber include dispersibility in water, bulk, viscosity, adsorption and binding of compounds and fermentability. Dietary fructans share some of the properties of dietary ﬁber and thus are likely to have similar metabolic effects. Within the small intestine, properties such as dispersibility in water, bulking and viscosity are associated with slowing the digestion and absorption of carbohydrate and lipid and promoting nutrient absorption along a greater length of the small intestine. Both of these actions are related to cholesterol reduction and blunting of alimentary gylcemia. Although fructans are dispersible in water and will provide some bulk because they are nondigestible in the small intestine, they do not appear to be associated with signiﬁcant increases in viscosity. Thus one would predict that any immediate effects on alimentary glycemia or on cholesterol reduction are likely to be modest compared with more viscous polysaccharides. Fermentability and bulking capacity of nondigestible carbohydrates deﬁne an essential role of ﬁber in maintaining gastrointestinal health. Within the large intestine, carbohydrates that are not digested in the small intestine are available for fermentation by the microﬂora present. Carbohydrates that are dispersible in the aqueous phase are more readily digested by microbes. A large body of evidence indicates that dietary fructans are digested in the large intestine, resulting in an increase in microbial mass and production of short-chain fatty acids. J. Nutr. 129: 1424S–1427S, 1999.
Cyclic fatigue resistance of ProTaper Next nickel-titanium rotary files.

AIM To compare the cyclic fatigue resistance of ProTaper Next files (PTN; Dentsply Maillefer, Ballaigues, Switzerland) with Twisted Files (TF; SybronEndo, Orange, CA, USA), HyFlex CM (HF; ColténeEndo/Whaledent, Inc, Cuyahoga Falls, OH, USA) and ProTaper Universal (PT; Dentsply Maillefer). METHODOLOGY Size 25, . 06 taper for PTN X2, TF, HF and PT F1 size 20, . 07 taper were rotated in simulated canals until failure, and the number of cycles to failure (NCF) was recorded to evaluate their cyclic fatigue resistance. A scanning electron microscope was used to characterize the topographic features of the fracture surfaces of broken files. The data of the NCF and fragment length values were analysed statistically using one-way analysis of variance and Tukey post hoc tests. Statistical significance level was set at P < 0.05. RESULTS Twisted Files had a significantly higher resistance to cyclic fatigue than the other instruments (P < 0.05). No significant difference was found in NCF between PTN and HF (P > 0.05); however, there was a significant difference (P < 0.05) of both these systems with PT, which exhibited the lowest mean NCF. The ranking in the NCF values was: TF > PTN > HF > PT. The fracture cross-sections of all brands revealed similar fractographic features, including crack origins, fatigue zone and an overload fast fracture zone. CONCLUSIONS The new ProTaper Next had greater resistance to cyclic fatigue compared with ProTaper and HyFlex CM but not the Twisted Files.
Historical perspective on garlic and cardiovascular disease.

Cardiovascular disease is a complex and multifactorial disease characterized by such factors as high cholesterol, hypertension, reduced fibrinolysis, increase in blood-clotting time and increased platelet aggregation. Dietary therapy is the first step in the treatment of hyperlipidemia; garlic has been used medicinally for centuries and is still included in the traditional medicine of many cultures. Historically, there has been great interest in the role of garlic in reducing cardiovascular risk factors. Evidence from numerous studies points to the fact that garlic can bring about the normalization of plasma lipids, enhancement of fibrinolytic activity, inhibition of platelet aggregation and reduction of blood pressure and glucose. However, some contradictory results have also emerged as a result of methodological shortcomings, the use of different formulations/preparations of garlic and different time scales of the studies. Accordingly, further clinical studies are required in which standardized formulations of garlic with known compositions can be used. Such formulations (e.g., Aged Garlic Extract) are now available and are being investigated. Evidence obtained from these studies indicates that garlic has potential in the prevention and control of cardiovascular disorders and is beneficial when taken as a dietary supplement.
Guidelines: An Exploration and Discussion

The goal of this article was to explore the structure and evaluation of guidelines and to discuss those features applicable to the librarian serving clinicians, thereby meeting the suggestions for guidelines that the Institute of Medicine (IOM) initially suggested in 1990. A literature search of major biomedical databases was undertaken. In addition, organizations and textbooks were consulted. The search discovered components of guidelines in general, evaluation tools for those components, and a few evaluation tools for the guidelines themselves. A further exploration revealed attributes of guideline formation and development that serve to clarify both their value and limitations. It was determined that GRADE (Grading of Recommendations Assessment, Development, and Evaluation) most nearly meets the IOM’s recommendations. Its widespread acceptance, incorporation of patient values and/or preferences, and its inclusion of studies other than randomized controlled trials make it uniquely suitable to clinical practice.
Negative pressure wound therapy for partial-thickness burns.

BACKGROUND A burn wound is a complex and evolving injury, with both local and systemic consequences. Burn treatments include a variety of dressings, as well as newer strategies, such as negative pressure wound therapy (NPWT), which, by means of a suction force that drains excess fluids from the burn, tries to promote the wound healing process and minimise progression of the burn wound. OBJECTIVES To assess the effectiveness of NPWT for people with partial-thickness burns. SEARCH METHODS We searched the Cochrane Wounds Group Specialised Register (searched 04 September 2014); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 8). SELECTION CRITERIA All randomised controlled trials (RCTs) and controlled clinical trials (CCTs) that evaluated the safety and effectiveness of NPWT for partial-thickness burns. DATA COLLECTION AND ANALYSIS Two review authors used standardised forms, and extracted the data independently. We assessed each trial for risk of bias, and resolved differences by discussion. MAIN RESULTS One RCT, that was an interim report, satisfied the inclusion criteria. We undertook a narrative synthesis of results, as the absence of data and poor reporting precluded us from carrying out any formal statistical analysis. The trial was at high risk of bias. AUTHORS' CONCLUSIONS There was not enough evidence available to permit any conclusions to be drawn regarding the use of NPWT for treatment of partial-thickness burn wounds.
A preeclampsia-like syndrome characterized by reversible hypertension and proteinuria induced by the multitargeted kinase inhibitors sunitinib and sorafenib.

The oral multitargeted kinase inhibitors (MTKI) sunitinib (SU11248, Sutent; Pfizer, New York) and sorafenib (BAY 43-9006, Nexavar; Bayer Pharmaceuticals, West Haven, CT, and Onyx Pharmaceuticals, Emeryville, CA) are increasingly used to treat malignant solid tumors. These small-molecule agents inhibit signaling through receptor tyrosine kinases such as vascular endothelial growth factor (VEGF) receptor, platelet-derived growth factor receptor, and c-KIT, among others (1). In the kidney, glomerular podocytes express VEGF and glomerular endothelial cells express VEGF receptors. Podocyte-specific deletion of a single VEGF allele causes proteinuria and capillary endotheliosis in rodents, and disrupted glomerular VEGF signaling is strongly implicated in the pathogenesis of human preeclampsia (2–4).
Intrinsic resistance of tumorigenic breast cancer cells to chemotherapy.

BACKGROUND Tumorigenic breast cancer cells that express high levels of CD44 and low or undetectable levels of CD24 (CD44(>)/CD24(>/low)) may be resistant to chemotherapy and therefore responsible for cancer relapse. These tumorigenic cancer cells can be isolated from breast cancer biopsies and propagated as mammospheres in vitro. In this study, we aimed to test directly in human breast cancers the effect of conventional chemotherapy or lapatinib (an epidermal growth factor receptor [EGFR]/HER2 pathway inhibitor) on this tumorigenic CD44(>) and CD24(>/low) cell population. METHODS Paired breast cancer core biopsies were obtained from patients with primary breast cancer before and after 12 weeks of treatment with neoadjuvant chemotherapy (n = 31) or, for patients with HER2-positive tumors, before and after 6 weeks of treatment with the EGFR/HER2 inhibitor lapatinib (n = 21). Single-cell suspensions established from these biopsies were stained with antibodies against CD24, CD44, and lineage markers and analyzed by flow cytometry. The potential of cells from biopsy samples taken before and after treatment to form mammospheres in culture was compared. All statistical tests were two-sided. RESULTS Chemotherapy treatment increased the percentage of CD44(>)/CD24(>/low) cells (mean at baseline vs 12 weeks, 4.7%, 95% confidence interval [CI] = 3.5% to 5.9%, vs 13.6%, 95% CI = 10.9% to 16.3%; P < .001) and increased mammosphere formation efficiency (MSFE) (mean at baseline vs 12 weeks, 13.3%, 95% CI = 6.0% to 20.6%, vs 53.2%, 95% CI = 42.4% to 64.0%; P < .001). Conversely, lapatinib treatment of patients with HER2-positive tumors led to a non-statistically significant decrease in the percentage of CD44(>)/CD24(>/low) cells (mean at baseline vs 6 weeks, 10.0%, 95% CI = 7.2% to 12.8%, vs 7.5%, 95% CI = 4.1% to 10.9%) and a statistically non-significant decrease in MSFE (mean at baseline vs 6 weeks, 16.1%, 95% CI = 8.7% to 23.5%, vs 10.8%, 95% CI = 4.0% to 17.6%). CONCLUSION These studies provide clinical evidence for a subpopulation of chemotherapy-resistant breast cancer-initiating cells. Lapatinib did not lead to an increase in these tumorigenic cells, and, in combination with conventional therapy, specific pathway inhibitors may provide a therapeutic strategy for eliminating these cells to decrease recurrence and improve long-term survival.
The correlates of natural method use in Moldova: is natural method use associated with poverty and isolation?

The Republic of Moldova demonstrates the highest reliance on natural contraceptive methods in Europe, and natural methods account for an increasing proportion of contraceptive mix since 1997. This study investigates method use correlates in Moldova in order to explain this high reliance on natural methods. The study tests hypotheses that current natural method use is associated with economic disadvantage and spatial isolation. The impact of national Family Planning (FP) is also examined by testing the significance of FP media exposure. The study controls for the effect of fertility preferences and coital activity on odds of natural method use. Data are drawn from the MDHS 2005- the first ever European DHS. The study population consists of 5860 women who had first sex, and were not pregnant. The effect of correlates is assessed using a multilevel, multinomial logistic regression model, accounting for cluster level effects. Findings support the hypothesis that economic disadvantage is associated with natural method use. Region and rural residence increase the probability of natural contraceptive use- although FP clinic access has no direct effect. Exposure to FP media decreases the odds of no method use, but the effect declines with age and there is no significant effect on natural method use. Women unaware of how to avoid AIDS are significantly more likely to be non-users. This study recommends that FP effort should be directed toward the poorest women by ensuring contraception is affordable and appropriate, and enhancing existing FP media to focus on women unaware of AIDS transmission routes.
Metabolic Defects Tied to Mitochondrial Gene

MEDICINEFindings published online this week by Science ([www.sciencemag.org/cgi/content/abstract/1102521][1]) point to an unexpected new culprit in metabolic syndrome, in which high blood pressure comes hand in hand with other cardiovascular risk factors such as diabetes and high blood concentrations of cholesterol and triglycerides. [1]: http://www.sciencemag. org/cgi/content/abstract/1102521