Notes

Using the transtheoretical type of behavior plunge to analyze the effect involving halting workout: a reflection.
Post-fistula-repair incontinence (PFRI) is a common complication of vesicovaginal fistula (VVF) surgeries. It entails continuous leakage of urine after successful VVF closure. Pelvic Floor Muscle Training (PFMT) plays a vital role in the management of PFRI, however, an evolving exercise approach is the Paula Exercise Method (PEM) which has shown a promising effect in stopping urinary incontinence, but there is no data on its effect on PFRI. This study therefore, proposes to primarily investigate the effect of PEM on urine leakage and secondarily, pelvic floor strength (PFS), quality of life (QoL), sexual function (SF), and mental health (MH) in women with PFRI.

This is a study protocol for a randomized controlled trial. A total of 182 participants are expected to participate in the study after satisfying the inclusion criteria. The participants will be randomized into either PEM or PFMT study groups. The demographic data of all the participants will be recorded. Each participant will be assessed for urine leakage, PFS, QoL, SF, and MH at baseline and subsequently, at four, eight and 12weeks of intervention. Demographic parameters will be summarized using descriptive statistics. Continuous data will be computed for differences using inferential statistic of Analysis of variance, t-test and Man Whitney U as appropriate. All analyses will be performed using SPSS version 22.0 with probability set at 0.05 alpha level.

It is hoped that the outcome of this study will determine the effect of the Paula exercise method on urine leakage, pelvic floor strength, quality of life, sexual function, and mental health among women with post-fistula-repair incontinence and also provide evidence for the use of the Paula method in urinary incontinence.

Pan African Clinical Trials Registry ( www.pactr.org ), identifier PACTR201906515532827.
Pan African Clinical Trials Registry ( www.pactr.org ), identifier PACTR201906515532827.
In the intensive care unit (ICU), delirium is a common, acute, confusional state associated with high risk for short- and long-term morbidity and mortality. Machine learning (ML) has promise to address research priorities and improve delirium outcomes. However, due to clinical and billing conventions, delirium is often inconsistently or incompletely labeled in electronic health record (EHR) datasets. Here, we identify clinical actions abstracted from clinical guidelines in electronic health records (EHR) data that indicate risk of delirium among intensive care unit (ICU) patients. We develop a novel prediction model to label patients with delirium based on a large data set and assess model performance.

EHR data on 48,451 admissions from 2001 to 2012, available through Medical Information Mart for Intensive Care-III database (MIMIC-III), was used to identify features to develop our prediction models. Five binary ML classification models (Logistic Regression; Classification and Regression Trees; Random Forets limit clinical applications of ML in delirium. We developed a novel labeling model for delirium in the ICU using a large, public data set. By using guideline-directed clinical actions independent from risk factors, treatments, and outcomes as model predictors, our classifier could be used as a delirium label for future clinically targeted models.
Gasless trans-axillary endoscopic thyroidectomy (GTAET) has satisfactory cosmetic effects for the patients who have benign goiter and small thyroid carcinoma, however the complications of this surgical procedure have not been fully documented. Ipsilateral hypoglossal nerve palsy (IHNP) associated with GTAET has never been reported before.

A 33-year old male patient presented with a 4 × 5mm solid thyroid nodule in the right lobe. Papillary thyroid carcinoma was confirmed by the fine needle aspiration. He had strong cosmetic demand, therefore GTAET for right lobectomy and central cervical lymphadenectomy was performed in a supine position with cervical extension. Six hours after the operation, he developed tongue deviation to the right side, speech and swallowing difficulties, indicating IHNP. Head and cervical MRI showed no abnormality. The intravenous steroid was used for three days, and oral vitamin B1 and mecobalamin was prescribed for 1 month. Nine days after surgery, he was discharged. Three months after the operation, all the symptoms were completely resolved.

To the best of the authors' knowledge, this is the first case of IHNP after GTAET, which will be valuable to add our knowledge to diagnose and treat rare complications of GTAET.
To the best of the authors' knowledge, this is the first case of IHNP after GTAET, which will be valuable to add our knowledge to diagnose and treat rare complications of GTAET.
Phyllanthus tenellus Roxb. has been traditionally used to treat inflammation and liver diseases and its medicinal property may be due to the presence of relatively high levels of hydrosable tannins. Recent report revealed that pressurized hot water extraction of P. tenellus significantly increased the concentration of hydrolysable tannins and its catabolites. Thus, this study was aimed to evaluate the in vivo toxicity and antioxidant capacity of pressurized hot water extraction of P. tenellus on healthy mice.

Pressurized hot water extraction P. tenellus was carried out and standardized to 7.9% hydrosable tannins. In vitro toxicity of the extract was tested on NIH 3 T3 cell by MTT assay. The cellular antioxidant level was quantified by measuring cellular level of glutathione. Oral sub-chronic toxicity (200, 1000 and 3000 mg/kg body weight) of P. tenellus extract were evaluated on healthy mice. Liver and kidney antioxidant level was quantified by measuring levels of Ferric Reducing Antioxidant Potential (FRin both liver and kidney without causing any acute and sub-chronic toxicity in the mice.
P. tenellus extract standardized with 7.9% hydrosable tannins and their catabolites increased the antioxidant levels while reducing the nitric oxide levels in both liver and kidney without causing any acute and sub-chronic toxicity in the mice.
Social enterprises are organizations created to address social problems that use business models to sustain themselves financially. Social enterprises can help increase access to primary health care in low resource settings. Research on social enterprises in health care have focused either on high-income countries, or on secondary and tertiary care in low- and middle-income countries, where common business models include differential pricing to cross-subsidize low income populations. selleck kinase inhibitor This is the first study to examine social enterprises providing primary health care in low- and middle-income countries using primary data. The purpose is to determine whether social enterprise is a viable model in this setting and to identify common patterns and characteristics that could inform the work of social entrepreneurs, funders, and researchers in this area.

We identify social entrepreneurs working to deliver primary healthcare in low- and middle-income countries who have been vetted by international organizations dedicated to supporting social entrepreneurship.
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