Miracle-dz/UniFAR-FTUs huggingface dataset:
Unusual Case of Prosthetic Shoulder Joint Infection Due to Clostridium difficile

Abstract:Extraintestinal manifestatation such as prosthetic joint infection due to Clostridium difficile is a rare diagnosis. A 47-year-old female patient presented with chronic pain in left shoulder prosthetic joint. Plain roentgenogram of left shoulder prosthetic joint revealed anterior dislocation and loosening of prosthesis. The synovial fluid cultures and intraoperative deep joint cultures repeatedly grew Clostridium difficile. Patient was treated with antimicrobial therapy and surgical debridement with complete removal of hardware and revision arthroplasty.
Approach to learning of medical students in a Caribbean medical school

METHODS: Student learning approaches were studied using the Approaches and Study Skills Inventory (ASSIST) instrument during the last week of September 2013. Demographic information like age, gender, semester of study, whether the respondent had completed a graduate course of study, nationality and whether the student had completed a premedical course was noted. The median scores among different subgroups of respondents were compared using appropriate non-parametric tests (p<0.05).
Age at diagnosis of diabetes in a secondary care population: 1992—2005

To assess the change in age at diagnosis of diabetes over time in a secondary care diabetes clinic, clinical characteristics of patients attending were compared in 1992 and 2005. Those of European and South Asian origins were analysed separately.Results In 1992, 28.4% of patients of European and 7.5% of patients of South Asian origins had type 1 diabetes. These proportions were similar in 2005. Mean age at diagnosis of type 1 diabetes remained unchanged from 1992 to 2005: Europeans: 20.6 versus 20.2 years (p=0.63) and in South Asians: 23.7 versus 21.3 years (p=0.21). By contrast the age at diagnosis of type 2 diabetes was younger in both groups in 2005 compared with 1992: Europeans: 54.0 versus 57.1 years (p<0.001). South Asians: 47.5 versus 49.0 years (p=0.003). Conclusions These data suggest an earlier age at diagnosis of type 2 diabetes in those of both, European and South Asian origin over 13 years of study.
Evaluation of analgesic and antiinflammatory activity of Ophiorrhiza nicobarica, an ethnomedicine from Nicobar Islands, India

SUMMARY This study reports the analgesic, anti-inflammatory and membrane-stabilizing property of alcoholicextract of Ophiorrhiza nicobarica (ON), a wild herb, used as an anti-infective ethnomedicine ofNicobarese and Shompen tribes of Great Nicobar Island, India. We for the first time investigated theanalgesic and antiinflammatory potential of this herb in acute, subacute and chronic model ofinflammation in Swiss albino mice and Wistar albino rats, along with sheep RBC-induced sensitivityand membrane stabilization. The acetic acid induced writhing, tail flick and tail immersion tests areused as a model for evaluating analgesic activity; while the carrageenin-induced paw oedema wasused as the model for acute inflammation, dextran-induced oedema as sub-acute and cotton-pellate-induced granuloma as chronic inflammatory model. The probable mode by which ON mediate itseffect on inflammatory conditions was studied on sheep RBC-induced sensitivity and membranestabilization. The in vitro results revealed that the ON extract possesses significant (P < 0.05) dosedependent analgesic and antiinflammatory activity at 200 and 300 mg/kg and its fractions at 50 mg/kg, p.o. respectively, compared to the control groups. However, the extract failed to exhibitmembrane-stabilizing property as it unable to reduce the level of haemolysis of RBC exposed tohypotonic solution. The acute toxicity studies of ON extract in rats and mice revealed that the extractwas nontoxic even up to 3.0 g/kg body weight of the animals, with a high safety profile. We haveisolated ursolic acid, β-sitosterol and harmaline respectively, from the bioactive part of the extract. Theresults indicated that the O. nicobarica is indeed beneficial in primary health care, and suggest that itsanti-inflammatory activity may not be related to membrane-stabilization.Key words: Ophiorrhiza nicobarica; Analgesic activity; Anti-inflammatory activity; Membrane-stabilizing property
MEDICAL TREATMENT OF PEPTIC ULCER WITHOUT ALKALIS

The large majority of cases of peptic ulcer which are capable of developing granulations and which are free from serious complications, such as profuse and repeated hemorrhages, perforation, perigastritis and periduodenitis with abscess, phlegmonous gastritis, hour-glass stomach, perhaps burrowing and deep penetration as revealed on the roentgenogram, organic pyloric obstruction and duodenal diverticulum, will heal readily under medical treatment no matter whether they are gastric, pyloric or duodenal. This holds true even in cases in which there is a moderate degree of retention of the gastric contents or a digestive or intermittently continuous hypersecretion with or without spastic or inflammatory pyloric obstruction. In deciding on a medical treatment of peptic ulcer, one should take into consideration not so much the causation of the ulcer as the factors that prevent its healing. No matter what fundamental cause brought on the ulcer, it is a thing of the past and cannot be
How can lipid nanocarriers improve transdermal delivery of olanzapine?

Abstract The development of a transdermal nanocarrier drug delivery system with potential for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, is described. Lipid nanocarriers (LN), encompassing various solid:liquid lipid compositions were formulated and assessed as potential nanosystems for transdermal delivery of olanzapine. A previously optimized method of hot high pressure homogenization (HPH) was adopted for the production of the LN, which comprised solid lipid nanoparticles (SLN), nanostructured lipid carriers (NLC) and nanoemulsions (NE). Precirol ® was selected as the solid lipid for progression of studies. SLN exhibited the best performance for transdermal delivery of olanzapine, based on in vitro release and permeation studies, coupled with results from physicochemical characterization of several solid:liquid lipid formulations. Stability tests, performed to give an indication of long-term storage behavior of the formulations, were in good agreement with previous studies for the best choice of solid:liquid lipid ratio. Overall, these findings highlight the SLN-based formulation as promising for the further inclusion in and production of transdermal patches, representing an innovative therapeutic approach.
Continuing professional development: Western Australian radiographers' opinions and attitudes

Purpose: The Australian radiography profession is currently moving towards compulsory continuing professional development (CPD) participation. An understanding of radiographer's attitudes and opinions towards CPD will assist in providing a CPD programme that meets the needs of radiographers. The aim of this study was to determine Western Australian radiographers' attitudes and opinions towards CPD and the programme that is currently being run by the Australian Institute of Radiography. Methods: Two-hundred and seventy-seven questionnaires about CPD were distributed to metropolitan clinical centres across Perth and 15 rural centres in Western Australia. Results: A total of 192 questionnaires were returned. A response rate of 64% was achieved for the metropolitan area (178/277). Among all respondents, 88% were currently engaged in CPD and the group of age 50+ had the highest percentage (78.1%) of respondents who believed CPD to be very important. Updating professional knowledge (79%) and maintaining professional competence (75%) were the most popular reasons for participating in CPD. Participants reported that time constraints and workload are barriers to CPD participation. Employer initiated CPD was most favoured; with in-house education and workplace seminars as suggested methods to increase CPD participation. Conclusion: This study demonstrated that decreased participation rates in CPD were mainly due to time constraints and workloads. Participation in CPD programmes is likely to be increased with more in-house education and workplace seminars. Changes need to be made to the current CPD programme to improve its accessibility and usability.
Dementia and mild cognitive impairment in adults with intellectual disability: issues of diagnosis.

Individuals with intellectual disability (ID) are now living longer with the majority of individuals reaching middle and even "old age. " As a consequence of this extended longevity they are vulnerable to the same age-associated health problems as elderly adults in the general population without ID. This includes dementia, a general term referring to a variety of diseases and conditions causing substantial loss of cognitive ability and functional declines; adults with Down syndrome are at especially high risk. A great deal of recent effort has focused on the very earliest detectable indicators of decline (and even prodromal stages of dementia-causing diseases). A condition called mild cognitive impairment (MCI) has been conceptually defined as a decline in functioning that is more severe than expected with typical brain aging but not severe enough to meet criteria for a diagnosis of dementia. Consensus criteria for both dementia and MCI have been developed for typically developing adults but are of limited applicability for adults with ID, given their pre-existing cognitive impairments. Early diagnosis will continue to be of growing importance, both to support symptomatic treatment and to prevent irreversible neuropathology when interventions are developed to slow or halt the progression of underlying disease. While the intellectual and developmental disabilities field has for some time recognized the need to develop best-practices for the diagnosis of MCI and dementia, there remains a pressing need for empirically based assessment methods and classification criteria.
Interpretation of the Paucicellular Thyroid Fine Needle Aspiration Biopsy Specimen

Fine needle aspiration (FNA) of the thyroid is the most common diagnostic modality used for the evaluation of thyroid nodules. The sensitivity of FNA of the thyroid is highly variable as are criteria used for assessment of adequacy. The author presents a case illustrating a common pitfall in FNA interpretation, which is a common source of error.
THE FACTOR OF IMMUNIZATION IN THE RAT

Using a popliteal lymph node weight assay the graft-versus-host activity of lymphocytes from donors immunized with allogeneic tissue has been assayed by comparison with that of lymphocytes from nonimmune donors. When the donors were immunized against weak histocompatibility antigens (non-AgB) the specific GVH activity of its lymphocytes was increased. This increase was greater if spleen cells rather than thoracic duct lymphocytes were the source of the donor cells used for assay. The increase in GVH activity was also greater if the standard immunization procedure of two successive skin allografts was followed by three boosting injections of allogeneic lymphoid cells. When donors were immunized against strong histocompatibility antigens the specific GVH activity of the donors' lymphocytes was slightly increased, was unchanged, or was actually decreased depending on the experimental situation. In donors rendered incapable of a humoral alloantibody response by whole body X-irradiation, immunization across a strong barrier was followed by little or no increase in the specific GVH activity of TDL. In the rat, as in other species, the increase in GVH activity after immunization is inversely proportional to the strength of the antigenic barrier involved.
Almost automatic method for reconstruction 3D geometric model of the left ventricle from 3D + 1D precordial echocardiogram

Echocardiography is the most convenient means for both physicians and patients for heart disease diagnosis. The 3D + 1D echocardiogram provides important information for evaluation of the 3D heart function such as the ejection fraction or wall motion. The most basic task to evaluate such functions of a heart is to segment left ventricles and reconstruct the 3D geometric model of left ventricle from a set of echocardiographic images. Since there are many images involved, the method should not need too many user assists. In this work, we design a method for reconstructing the left ventricles with very few user assists.
New Techniques for Labor Analgesia

In the most recent survey (1997), results indicate that more than 50% of women in the United States have a regional anesthetic during labor (Table 1) (1). About 50% have parenteral medications, either alone or before receiving regional analgesia. Only about 10% of parturients receive no analgesia, but these women might incorporate “natural childbirth” techniques such as ambulation, warm water, breathing exercises, hypnosis, acupuncture, doula attendants (2), etc. Anesthesiologists are not usually involved with these patients, nor are we usually involved in the selection of single-dose parenteral medications. However, anesthesiologists can add to the analgesic options available to the patient.
Welfare Monitoring Schemes: Using Research to Safeguard Welfare of Animals on the Farm

There are a number of nonhuman animal welfare monitoring schemes for animals on the farm in Australia and in other countries. Although the majority of such schemes are voluntary rather than legislated, some are nevertheless enforced through a number of customer requirements that industries must meet to gain access to markets. Animal welfare monitoring schemes rely on a number of measures, but the majority are based on simple measures of resource or management inputs with fewer animal-based measures; few are specific to animal welfare outcomes. Furthermore, most measures are used retrospectively, particularly where there has been a problem, to improve welfare for the next “batch” of animals and thus few measures can be used to predict animal welfare outcomes with these schemes. There is considerable uncertainty about the concept and consequently the measurement of animal welfare. Science has a clear contribution to make in forging better agreement on animal welfare assessment and also has important roles in both developing practical animal-based measures of animal welfare and validating that animal welfare monitoring schemes are worthwhile in improving at least some aspects of animal welfare.
Neuroendocrine responses to social isolation and paternal deprivation at different postnatal ages in Mandarin voles.

Neonatal isolation and paternal deprivation have long lasting effects on the behavior and neuroendocrine system at adulthood. Whether these effects at adulthood are induced by neonatal changes in relevant neuroendocrine parameters lead by these early-life social experiences is not well understood. Whether monogamous rodents exhibit a stress hypo-responsive period (SHRP) also remains unclear. Using the monogamous mandarin vole, we found that 30 min of isolation did not affect levels of corticosterone (CORT) and adrenocorticotropin (ACTH) at postnatal days 8, 10, and 12 displaying a SHRP, but increased these at postnatal days 4, 14, 16, and 18. Isolation increased vasopressin (AVP)-ir neurons in the paraventricular nucleus (PVN) and supraoptic nucleus (SON) from postnatal days 4 to 12, and up-regulated oxytocin (OT)-ir neurons in the PVN at postnatal days 4 and 8 and SON at postnatal day 4. Paternally deprived pups showed increase in ACTH and CORT after 30 min of social isolation from postnatal days 8 to 14, increase in AVP-ir neurons in the PVN from postnatal days 10 to 14, reduction in OT-ir neurons in the PVN from postnatal days 10 to 14 and in the SON at postnatal days 12 and 14. These results indicate that monogamous mandarin voles display a short SHRP which can be disrupted by paternal deprivation. Central AVP and OT levels may also be altered by paternal deprivation and social isolation. We propose that changes in these neuroendocrine parameters induced by early-life social experiences such as those tested here persist and result.
Dog Obesity: Can Dog Caregivers' (Owners') Feeding and Exercise Intentions and Behaviors Be Predicted From Attitudes?

Dog obesity is a common nutritional disorder affecting up to 40% of the companion animal (pet) dog population in Australia and other developed nations. A clear understanding of factors determining relevant caregiver (owner) behaviors underpins effective treatment for this disorder. The theory of planned behavior can be used to understand factors contributing to human behavior. This article describes research informed by this theory. The research examined relationships between owners' behavioral beliefs and barriers, normative beliefs and perceptions of control, owners' feeding and exercise behaviors toward their dogs, and the body condition scores (BCSs) of dogs. The study recruited a sample of 182 dog and owner dyads. The researcher independently assessed BCSs. Owners completed a questionnaire measuring relevant feeding and exercise beliefs and behaviors. This revealed significant correlations between many psychological variables and BCSs and between psychological variables and specific owner behaviors: for example, the relationship of low levels of intentions to feed appropriately to ambivalent beliefs toward feeding appropriately and low perceived control. Careful consideration of the specific variables identified will permit the development of more effective interventions.
Effect of Postweaning Handling Strategies on Welfare and Productive Traits in Lambs

Postweaning management strategies that include an element of social enrichment may reduce weaning stress and improve welfare and productive performance. We analyzed the effect of postweaning handling strategies on welfare and production traits in lambs. After weaning, 36 lambs were assigned to 3 experimental groups with 12 lambs each (control [C], fattening with gentle human female contact [H], and fattening with 2 adult ewes [E]). The average daily gain (ADG) was estimated. Blood samples were taken, and infrared thermography was used to estimate stress variables. There were significant differences among treatments (in favor of alternative strategies) regarding production and stress variables (cortisol, glucose, and creatine kinase). The results suggest that the lambs handled gently during the fattening were less reactive and better able to modulate their physiological stress. The E group adapted better to acute stress than the C group but was less efficient in modulating chronic stress. Both treatments showed higher slaughter live weights and better ADGs compared with the control. The use of social enrichment at weaning, especially to establish a positive human–nonhuman animal bond, alleviates lamb weaning stress and improves welfare and performance.
Comparison of Subjective Well-Being and Personality Assessments in the Clouded Leopard (Neofelis nebulosa), Snow Leopard (Panthera uncia), and African Lion (Panthera leo)

The study of subjective well-being in nonhuman animals is growing in the field of psychology, but there are still only a few published studies and the focus is on primates. To consider whether the construct of subjective well-being could be found in another mammal, this study aimed to assess subjective well-being in felids and to examine its association with personality. Personality is one of the strongest and most consistent predictors of well-being in humans. This relationship could have important implications for other species, because personality has also been shown to affect health outcomes including stress, morbidity, and mortality. As in previous studies in nonhuman animals, the study results revealed that subjective well-being was related to agreeableness/openness and neuroticism in clouded leopards, neuroticism in snow leopards, and impulsiveness and neuroticism in African lions. The implications of these results for health outcomes and the welfare of animals in captivity are discussed. More research on any direct links among personality, subjective well-being, and these outcomes is important to advancing this field and adding another tool for improving captive animals' lives.
Testing Random Effects in the Linear Mixed Model Using Approximate Bayes Factors

Summary Deciding which predictor effects may vary across subjects is a difficult issue. Standard model selection criteria and test procedures are often inappropriate for comparing models with different numbers of random effects due to constraints on the parameter space of the variance components. Testing on the boundary of the parameter space changes the asymptotic distribution of some classical test statistics and causes problems in approximating Bayes factors. We propose a simple approach for testing random effects in the linear mixed model using Bayes factors. We scale each random effect to the residual variance and introduce a parameter that controls the relative contribution of each random effect free of the scale of the data. We integrate out the random effects and the variance components using closed‐form solutions. The resulting integrals needed to calculate the Bayes factor are low‐dimensional integrals lacking variance components and can be efficiently approximated with Laplace's method. We propose a default prior distribution on the parameter controlling the contribution of each random effect and conduct simulations to show that our method has good properties for model selection problems. Finally, we illustrate our methods on data from a clinical trial of patients with bipolar disorder and on data from an environmental study of water disinfection by‐products and male reproductive outcomes.
Improving Power for Testing Genetic Association in Case–Control Studies by Reducing the Alternative Space

Summary To detect association between a genetic marker and a disease in case–control studies, the Cochran–Armitage trend test is typically used. The trend test is locally optimal when the genetic model is correctly specified. However, in practice, the underlying genetic model, and hence the optimal trend test, are usually unknown. In this case, Pearson's chi‐squared test, the maximum of three trend test statistics (optimal for the recessive, additive, and dominant models), and the test based on genetic model selection (GMS) are useful. In this article, we first modify the existing GMS method so that it can be used when the risk allele is unknown. Then we propose a new approach by excluding a genetic model that is not supported by the data. Using either the model selection or exclusion, the alternative space is reduced conditional on the observed data, and hence the power to detect a true association can be increased. Simulation results are reported and the proposed methods are applied to the genetic markers identified from the genome‐wide association studies conducted by the Wellcome Trust Case–Control Consortium. The results demonstrate that the genetic model exclusion approach usually performs better than existing methods under its worst situation across scientifically plausible genetic models we considered.
Exercise as therapy? Results from group interviews with general practice teams involved in an inner-London 'prescription for exercise' scheme

As part of an inner-London 'prescription for exercise' scheme, group interviews were conducted with clinical and support staff from participating general practices. Interviews took place between August and November 1995 to identify the practices' reasons for joining the scheme, the perceived health benefits to patients of the scheme, and criteria for selection and referral of patients onto the scheme. The results showed that the referring practice members saw exercise promotion as a therapeutic option, rather than an instrument for primary prevention. They were cautious in their referral criteria because of family health services authority guidelines. If future schemes are to develop they must distinguish between these perspectives in their promotion of physical activity.