Miracle-dz/UniFAR-FTUs huggingface dataset:
Experience of Long-term Care Workers' Communication with Older Adults with Dementia Focused on Emotional Expression

Purpose: The purposes of this study were to understand (1) emotional expression of older adults with dementia and (2) communication between long-term care workers and older adults with dementia. Methods: Ten long-term care workers who provided care services for older adults with dementia in long-term care were interviewed. Qualitative content analysis was conducted to reveal themes and subthemes. Results: Participants stated that they tried to learn emotional expressions in older adults with dementia, but it was difficult due to emotional fluctuation in older adults with dementia. Care workers attempted to interact with older adults with dementia using verbal and non-verbal communication skills. They stated difficulties in verbal communication with older adults with dementia. In addition, care workers improved their tailored communication skills with the accumulation of care experience and noticed their care service value. Conclusion: It is meaningful to understand long-term care workers’ perceptions of emotional expression and communication among older adults with dementia in long-term care. Well-organized communication protocols should be provided for long-term care workers to enhance emotion-oriented and person-centered care services based on the needs and preferences of older adults with dementia.
Complex Endometrial Hyperplasia: Prevalence and Risk Factors for coexisting Endometrial Carcinoma

Objective : This study was planned to observe the prevalence of endometrial carcinoma in patients with complex endometrial hyperplasia. It has also assessed the risk factors for concomitant endometrial carcinoma. Materials and methods: Retrospective analysis of 71 patients with complex endometrial hyperplasia surgically treated between 1995 and 2015 in Aga Khan University Hospital, Karachi, Pakistan, was performed. Results : The prevalence rate of concurrent endometrial carcinoma in patients with endometrial hyperplasia was 34%. The rate for concurrent endometrial carcinoma in patients with complex hyperplasia with atypia was 49% as compared with 4.2% in patients without atypia. Cancer risk was significantly related to menopause (p = 0.043) and presence of atypia (p = 0.0005). Multivariate analysis to adjust for confounders revealed that cytological atypia [odds ratio (OR), 17.12; 95% confidence interval (CI), 2.07–141.42], menopause (OR, 2.07; 95% CI, 0.51–7.91), and hypertension (OR, 1.67; 95% CI, 0.51–5.44) were independent risk factors for endometrial hyperplasia coexisting with endometrial carcinoma Conclusion: The optimal management for menopausal women with complex hyperplasia along with atypia should be surgical intervention. We recommend that these women should be managed in centers where expertise and skills of adequate surgical staging are available.
Dynamics of serum levels of nitrogen oxide and hydrogen sulfide metabolites as markers of organ dysfunction in acute phase of multiple trauma

Актуальность. У пациентов с сочетанными травмами отмечается высокий уровне риска развития шока, осложнений и смерти. В наше время существуют системы оценки, которые позволяют установить степень тяжести политравмы и определяют прогноз заболевания, но их чувствительность значительно ограничена тем, что они являються субъективными. В последние годы большое внимание уделяется газовым трансмиттерам, к которым относятся оксид азота (NO), монооксид углерода (СО) и сульфид водорода (H 2 S). Поскольку производство газовых трансмиттеров многими типами клеток повышается при повреждении ткани, допускают, что их концентрация, а также концентрация продуктов их окисления в сыворотке крови представляют собой маркер политравмы, коррелирующий с прогнозом. Цель: определить степень нарушения эндотелиальной дисфункции и патогенетическую роль газотрансмиттеров как маркеров развития органной дисфункции в остром периоде политравмы. Материалы и методы. В работе приведены данные клинического обследования и лечения 28 больных с политравмой. Средний возраст пострадавших — 48,4 ± 5,2 года. В зависимости от тяжести пациентов при поступлении проведена стратификации по шкале APACHE II: 1-я группа (n = 22) — среднетяжелая политравма; 2-я группа (n = 6) — тяжелая поли­травма. Результаты. Происходило значительное уменьшение уровня нитроксида уже при госпитализации у пациентов 1-й и 2-й групп по сравнению с нормой — 0,49 ± 0,06 мкмоль/л, р = 0,001. Спустя сутки интенсивной терапии у пациентов обеих групп уровень NO крови возрастал до 0,43 ± 0,03 мкмоль/л и 0,45 ± 0,03 мкмоль/л соотвественно. При поступлении у пациентов межгрупповые отличия среднего уровня NOx крови были достоверными (р = 0,003). После проведения интенсивной терапии у пациентов обеих групп уровень NO 2 + NO 3 продолжал увеличиваться (р = 0,001 по сравнению с предыдущим этапом, а между группами статистически значимых отличий не было (р = 0,475). Средний уровень H 2 S в крови при поступлении пациентов 1-й и 2-й групп был достоверно выше нормы (р = 0,025). Отличия между группами были недостоверными (р = 0,117). Проведение интенсивной терапии сопровождалось норма­лизацией уровня H 2 S. Выводы. У больных с политравмой в остром периоде наблюдается развитие эндотелиальной ­дисфункции, которая подтверждается статистически значимыми изменениями уровня газо­трансмиттеров в сыворотке крови. Концентрации NO и продуктов его окисления (NOx) в сыворотке крови, определенные при госпитализации, являются чувствительными маркерами тяжести политравмы. Низкий уровень NOx у больных с крайне тяжелой травмой при госпитализации может прогнозировать не­благоприятный исход острого периода травматической болезни.
Infuence of Metabolic Syndrome on Hearing Outcome in Sudden Sensorineural Hearing Loss

Received October 20, 2017 Revised November 17, 2017 Accepted November 28, 2017 Address for correspondence Jong Bin Lee, MD, PhD Department of OtorhinolaryngologyHead and Neck Surgery, Konyang University College of Medicine, 158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea Tel +82-42-600-8840 Fax +82-42-543-8959 E-mail rogue25@chol.com Background and Objectives Sudden sensorineural hearing loss (S-SNHL) has been reported to be associated with hypertension, diabetes mellitus, hyperlipidemia, and stroke in previous studies. The purpose of this study was to confrm whether metabolic syndrome (MS) infuences the hearing outcome of S-SNHL in the Korean population. Subjects and Method We prospectively investigated the clinical variables of 231 cases of S-SNHL from 2010 March to 2014 February. MS was defned according to the National Cholesterol Education Program Adult Treatment Panel III with Asian modifcations. We analyzed and compared the basic and clinical characteristics, the thresholds of pure tone audiometry (PTA), and the hearing outcomes of patients with MS (MS group) and without MS (NMS group). Results There were no signifcant differences in the basic characteristics and initial hearing thresholds between the MS and NMS groups; on the other hand, there were signifcant differences in all of the clinical values of MS between the two groups. The average thresholds of final PTA for the MS and NMS groups were 52.9±30.9 dB and 40.5±27.2 dB, respectively, with meaningful diversity (p<0.01). According to Siegel’s criteria, the recovery rate of the NMS group (95/159, 59.7%) was signifcantly higher than those of the MS group (29/72, 40.3%). The proportion of recovery within 5 days after starting the treatment was signifcantly higher of the NMS group (37/95, 39.0%) than those of the MS group (4/29, 13.8%) (p<0.01). Conclusion The hearing outcome of the NMS group was signifcantly better than those of the MS group. Korean J Otorhinolaryngol-Head Neck Surg 2018;61(10):514-21
Calcaneal Fractures: A Soft Tissue Emergency

Calcaneal fractures are quite often seen in patients with axial loading injury. In the tongue-type of calcaneusal fractures or tuberosity avulsion fractures, bone fragments are often superiorly and posteriorly displaced, because of the insertion of the Achilles tendon and pull of the gastroc-soleus complex. The Ddisplaced bone fragment com-presses the soft tissues, leading tothat makes skin necrosis. To prevent further soft tissue injury, early recognition of the injury by the emergency physician and immediate orthopedic consultation is needed.
Review on Evidence Based Ayurvedic Treatment Practices for Psoriasis

Psoriasis is characterized by sharply defined erythematous squamous lesions. It is one of the commonest chronic, non-infectuous papulo-squamous disorder of the skin. Several treatment modalities are in existence in modern system of medicine; however they have limitations due to their side effects due to long time use. Considering this, search for new safe therapeutic regime in psoriasis is going on. The present paper presents some of the promising evidence based Ayurvedic therapeutic approaches in the management of psoriasis.
Older people’s experiences of getting help from neighbours

Purpose The purpose of this paper is to investigate older people’s views and experiences of getting help from neighbours in order to consider whether such help is situated within neighbourliness and the implications for social care policy which seeks to harness help from neighbours. Design/methodology/approach A qualitative study in which 15 older people from the North of England were interviewed to explore relationships with neighbours, managing day to day life and experiences of getting help from neighbours. Findings Relationships with helper neighbours were reciprocal, dynamic and preceded the start of getting help. The help offered was not negotiated but evolved in response to changes in circumstances and was commensurate with normative views of neighbourliness, i.e. reciprocated sociability and helpfulness but also respect for privacy. Respondents were reluctant to ask for help. Underpinning such reluctance were perceptions of imposing on neighbours, suggestive of anticipated asymmetry in the give-and-take of neighbourliness. Social implications Policy makers who see the help from neighbours as an output of household production and available as a source of informal care for older people must appreciate that whether help is offered or taken up is dependent on the development of a reciprocal relationship which itself depends on observing and respecting normative boundaries, such as in relation to help giving or receiving and due respect for privacy. Originality/value There has been little research into older people’s perspectives on getting help from neighbours despite diminishing public services and neighbours viewed as a potential source of care.
Activation of Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Induces Apoptosis in Cultured Neonatal Rat Cardiac Myocytes

Background— Lectin-like oxidized LDL receptor-1 (LOX-1) was originally identified as a receptor expressed predominantly in endothelial cells. LOX-1 can also be expressed in other cell types, and the activation of the LOX-1 pathway has been implicated in apoptosis. There have been no reports, however, about LOX-1 expression in cardiac myocytes or regulation of myocardial cell apoptosis by LOX-1. Methods and Results— In primary cardiac myocytes from neonatal rats, immunohistochemical analyses using a specific monoclonal antibody against LOX-1 demonstrated that LOX-1 expression was markedly induced by stimulation with norepinephrine and endothelin-1. LOX-1 expression was upregulated in cardiac myocytes as well as in vessel walls of failing rat hearts in vivo. In the presence of a low concentration of oxidized LDL that did not induce apoptosis by itself, artificial overexpression of LOX-1 in cardiac myocytes in culture resulted in apoptosis. LOX-1 overexpression induced activation of p38 mitogen-activated pro.
Adult women perception towards obesity and its intervention strategies in the community

Obesity was one of the health problems experienced in the society, especially in adult women and the number was increasing rapidly every year. The various factors contribute to the obesity occurrence in adult women and appropriate obesity prevention strategies must be taken. With reference to being needed exploring the obesity perception, its causes, and impact as well as countermeasures strategies based on the needs of the society itself. The study was intended to explore the society perception regarding obesity, ideal weight, and strategies that the society wanted in overcoming obesity. The study was a qualitative study. It was conducted in March-July 2017. The research subjects (participants) were women 25-50 years old, the leader of the Family Welfare education organization, and health workers (nutritionist) in Denpasar city about 22 people. The data were collected included obesity and weight perception, social determinants, the impact of obesity and opinions on obesity prevention strategies. The data were collected through the Focus Group Discussion (FGD) process in adult women, in-depth interviews with the leader of the Family Welfare education organization, and society leaders. It was analyzed and presented descriptively. The results showed that most of the participants stated obesity was identical to overweight. Obesity was a health problem that has an impact on the onset of chronic diseases e.g., diabetes, therefore, less of confidence self. An ideal weight was proportional become a desire. The most participants perceived themselves as fat and far from ideal. They did not want to be fat, however, the various inhibiting factors, unlike dietary habit, were difficult to change, the availability of fast food that was very easily accessible, work, less of exercise, transportation occurred lack of movement. They generally want a comprehensive program through eating arrangements, exercise regularly, education at improving knowledge, and education at balancing menu processing skills. It was carried out together by involving social groups in the community.
Spontaneous Hyperthermia and its Mechanism in the Intraluminal Suture Middle Cerebral Artery Occlusion Model of Rats

Background and Purpose—The intraluminal suture middle cerebral artery occlusion (MCAO) model is increasingly used in experimental stroke studies. The purposes of this study were to determine whether (1) spontaneous hyperthermia occurs after different periods of MCAO in this model, (2) hypothalamic injury contributes to hyperthermia, and (3) hyperthermia increases infarct volume after permanent MCAO. Methods—Rats were subjected to 60, 90, and 120 minutes of transient MCAO (n=8 per group), permanent MCAO (n=8 per group, 5 groups), and permanent hypothalamic occlusion, in which an occluder was inserted 15 to 15.5 mm to block only the hypothalamic branch from the internal carotid artery (n=4) with the use of the intraluminal suture MCAO method. In one group undergoing permanent MCAO, the body temperature was maintained at 37°C throughout the experiment. In another group (n=4) undergoing 90 minutes of temporary MCAO, diffusion- and perfusion-weighted imaging were performed to document the in vivo ischemic chan.
Potential risks related to anabolic steroids use on nervous, cardiovascular and reproductive systems disorders in men

Abstract Anabolic steroids (AS) have been a subject of intensive research for the last several decades. Due to wide use of AS in pharmacological treatment and in professional and amateur sport, it is, hence, worthwhile to describe the biochemical mechanism of the effects of AS usage in humans and its potential health risks. In this work, the relationship between diet and its effect on the level of testosterone in blood is described. Testosterone affects the nervous system, however, there is need for further researches to examine the influence of AS therapy on emotional and cognitive functioning. AS therapy has known negative effects on the cardiovascular system: cardiac hypertrophy can occur, blood pressure can vastly increased, thrombotic complications can come about. These effects are observed not only in patients who are treated with AS, but also in athletes. The paper also describes the relationship between AS and reproductive system diseases. Decreased libido and erectile dysfunction are only some of the many side effects of an incorrect AS treatment.
Antibiotic prophylaxis in a primary level hospital : a medicines use evaluation to assess compliance in caesarean sections.

ii DECLARATION . iii DEDICATION . iv ACKNOWLEDGMENTS . v ACRONYMS AND ABBREVIATIONS . vi LIST OF TABLES . x LIST OF FIGURES . xi CHAPTER I: INTRODUCTION . 1 1.1 Health and healthcare delivery in South Africa . 1 1.1.1 The public healthcare system . 2 1.1.2 The private healthcare system . 3 1.2 From the Millennium Development Goals to the era of Sustainable Development Goals . 3 1.3 Antimicrobial stewardship programmes and management of resistant organisms 5 1.4 Caesarean section as a means of delivery . 8 1.4. 1 Caesarean section rates in South Africa . 10 1.5 Problem statement . 11 1.6 Purpose of the research . 12 1.7 Aim and objectives of the study . 12 1.7. 1 Overall aim . 12 1.7. 2 Specific objectives . 12 1.8 Summary . 13 CHAPTER II: LITERATURE REVIEW . 14 2.
THE PUBERTY PROFILE OF FEMALE ADOLESCENTS IN CHERAS, MALAYSIA

Objectives: The objectives of our study were to determine the mean age of onset of thelarche and menarche, to determine the ages of each stage of puberty and to investigate if there are any ethnic differences in these ages amongst female adolescents in Kuala Lumpur, Malaysia.Methods: This was a cross-sectional study involving three secondary schools in Cheras, Kuala Lumpur. A total of 730 students were recruited via stratified random sampling. Self-administered survey forms on menstruation and puberty were used.Results: Out of 730 recruited respondents, 385 (52.74%) completed the survey and informed consents were obtained from their parents/legal guardians. Our respondents’ ages ranged between 13 to 17 years old with the median (IQR) age of 14.00(2.00) years. With regards to ethnicity, 329 (85.50%) were Malay, 46 (11.90%) were Chinese, 9 (2.30%) were Indian and 1(0.30%) was a Bajau. The mean age for breast development (thelarche) and menarche were 11.72 ±1.10 and 11.97±1.11 years respectively. The majority, 363 (94.30%), out of 385 respondents had attained menarche. There appeared to be a later onset of puberty amongst Malays comparatively.Conclusion: The mean ages of pubertal onset and menarche amongst female adolescents in the Cheras area are similar to those reported worldwide. Keywords: Puberty, Thelarche, Menarche, Pubertal Onset, Adolescents
ARE THE AGE OF MENARCHE AND THE AGE OF MENOPAUSE CORRELATED WITH BREAST CANCER MOLECULAR SUBTYPES

The purpose of the study was to determine wether the age of menarche, the age of menopause or the lenght of the period between them are somehow related to the molecular subtype of a breast tumour. Data from 438 women collected in the past 10 years (January 2007 – December 2017) from patients that were treated for breast cancer in the Oncology Department of the University Emergency Hospital Bucharest, Romania was analyzed in a retrospective, monocentric, descriptive manner. No statistical significant correlation between the three researched parameters and the molecular subtype of the breast cancer was found.
Evaluation of Visual Evoked Potential and Brainstem Auditory Evoked Potential in Migraine

AIM OF THE STUDY: The present study was undertaken to investigate the visual and brainstem auditory functions in Migraine patients. MATERIALS AND METHODS: The subjects were recruited from Outpatient Clinic of Department of Neuromedicine, Thanjavur Medical College & Hospital, Thanjavur based on International Headache Society classification for Migraine. Subjects with history suggestive of other types of headache, TTH, cluster headache, sinusitis and subjects with Visual field defects, Auditory deficits are excluded from the study. Forty subjects (16 with Aura & 24 cases – Migraine without aura) in the mean age group of 19 to 52 yrs & forty age / sex matched controls with no history of Headache were selected for the study. Informed written consent was obtained from the subject. Ethical committee approval was obtained from the Institution before commencing the study. A detailed history of Headache duration, frequency and history suggestive of aura and history to rule out other types of headache were noted. Ophthalmologic examination was done to determine visual acuity, Field of Vision, extraocular movements and pupillary diameter. The results were analysed statistically using student „t‟ test. RESULTS: There was significant prolongation of P100 & N145 latency (p<0.05) in both Migraine with aura and without aura compared with controls. BAEP recording shows significant prolongation of latency of Wave I, III & V and the Interpeak latency I-III, III-V & I-V in Migraine with aura. In Migraine without aura, there was significant prolongation of Wave I, III & V and only III-V IPL & I-V IPL. (p<0.05). CONCLUSION: The present study results show that there is involvement of the central nervous system Visual pathway and the Brainstem in Migraine patients. The Migraine patients show prolongation of latency in Electrophysiological studies. Migraine patients with aura and without aura show significant prolongation of P100, N145 Latency with no change in P100 amplitude and in BAEP the latencies of waves I , III & V and the IPLs I-III , III- V & I-V are prolonged. These findings suggest there is defect in the central processing of visual function and BAEP alterations suggest involvement of Brainstem structures during Migraine attack. Thus, VEP and Auditory brainstem evoked responses are considered as useful, non-invasive, reliable & diagnostic techniques for better understanding the Neurophysiological processes involved in Migraine patients which aid in the selection of adequate, effective treatment in Migraine subjects. However, further studies are needed to compare the duration of the disease with the changes in the Electrophysiological study and to explain the role of Neuromodulatory centers in the brainstem in pathophysiology of Migraine. Then, the role of pattern reversal check size on VEP parameters in Migraine patients and lack of habituation during prolonged stimulation should be evaluated.