Miracle-dz/UniFAR-FTUs huggingface dataset:
Transition to adulthood and adult health care for patients with sickle cell disease or cystic fibrosis: Current practices and research priorities

Abstract Introduction A growing population of adults living with severe, chronic childhood-onset health conditions has created a need for specialized health care delivered by providers who have expertise both in adult medicine and in those conditions. Optimal care of these patients requires systematic approaches to healthcare transition (HCT). Guidelines for HCT exist, but gaps in care occur, and there are limited data on outcomes of HCT processes. Methods The Single Disease Workgroup of the Lifespan Domain Task Force of the National Center for Advancing Translational Sciences Clinical and Translational Science Award programs convened a group to review the current state of HCT and to identify gaps in research and practice. Using cystic fibrosis and sickle cell disease as models, key themes were developed. A literature search identified general and disease-specific articles. We summarized key findings. Results We identified literature characterizing patient, parent and healthcare provider perspectives, recommendations for transition care, and barriers to effective transition. Conclusions With increased survival of patients with severe childhood onset diseases, ongoing study of effective transition practices is essential as survival increases for severe childhood onset diseases. We propose pragmatic methods to enhance transition research to improve health and key outcomes.
Can parents’ educational level and occupation affect perceived parental support and metabolic control in adolescents with type 1 diabetes?

BACKGROUND/AIM: Parents have an important role to play in supporting adolescents with type 1 diabetes mellitus (T1DM). Their education and occupation are important factors for the management of this disease. This study aimed to investigate the parental support that Iranian adolescents with T1DM experience and to examine the effect of parents' education and occupation on adolescents' perceived the parental support and metabolic control. METHODS: This is a cross-sectional survey. The participants were 98 adolescents (aged 11–18 years) with T1DM referred to Endocrinology Clinics of Shahid Rahimi and Shahid Madani hospitals in Khorramabad, Iran, in 2016. For evaluating the adolescents' perceptions of parental support, the family version of Diabetes Social Support Questionnaire was employed. It measures in five diabetic care areas (insulin administration, blood testing, meal planning, exercise, and emotional support). Data were analyzed in SPSS version 22 software using descriptive statistics and inferential tests including Pearson correlation test, ANOVA, and independent t-test. RESULTS: The parents' educational level had a significant relationship with adolescents' perceived parental support and hemoglobin A1c (HbA1c) level (P < 0.05). Occupation of father had no significant influence on his supportive behavior and HbA1c level in adolescents, but mother's occupation significantly influenced them (P < 0.05). In adolescents with higher perceived parental support, the mean HbA1c was lower. CONCLUSIONS: Parents with higher educational level can improve the metabolic control and provide better meal planning in adolescents with T1DM.
Long‐term declines in winter body mass of tits throughout Britain and Ireland correlate with climate change

Abstract The optimum body mass of passerine birds typically represents a trade‐off between starvation risk, which promotes fat gain, and predation pressure, which promotes fat loss to maintain maneuvrability. Changes in ecological factors that affect either of these variables will therefore change the optimum body masses of populations of passerine birds. This study sought to identify and quantify the effects of changing temperatures and predation pressures on the body masses and wing lengths of populations of passerine birds throughout Britain and Ireland over the last 50 years. We analyzed over 900,000 individual measurements of body mass and wing length of blue tits Cyanistes caeruleus, coal tits Periparus ater, and great tits Parus major collected by licenced bird ringers throughout Britain and Ireland from 1965 to 2017 and correlated these with publicly available temperature data and published, UK‐wide data on the abundance of a key predator, the sparrowhawk Accipiter nisus. We found highly significant, long‐term, UK‐wide decreases in winter body masses of adults and juveniles of all three species. We also found highly significant negative correlations between winter body mass and winter temperature, and between winter body mass and sparrowhawk abundance. Independent of these effects, body mass further correlated negatively with calendar year, suggesting that less well understood dynamic factors, such as supplementary feeding levels, may play a major role in determining population optimum body masses. Wing lengths of these birds also decreased, suggesting a hitherto unobserved large‐scale evolutionary adjustment of wing loading to the lower body mass. These findings provide crucial evidence of the ways in which species are adapting to climate change and other anthropogenic factors throughout Britain and Ireland. Such processes are likely to have widespread implications as the equilibria controlling evolutionary optima in species worldwide are upset by rapid, anthropogenic ecological changes.
Determinants of Maternal Death in a Pastoralist Area of Borena Zone, Oromia Region, Ethiopia: Unmatched Case-Control Study

Background Globally, more than 830 maternal deaths happen daily, and nearly, all of these occur in developing countries. Similarly, in Ethiopia, maternal mortality is still very high. Studies done in pastoralist women are almost few. Therefore, the objective of this study was to assess the determinant factors of maternal death in the pastoralist area of Borena zone, Oromia region, Ethiopia. Methods Community-based unmatched case-control study was conducted on 236 mothers (59 maternal deaths (cases) and 177 controls). The sample included pregnant women aged 15–49 years from September 2014 to March 2017. Data were collected using a structured questionnaire adapted from Maternal Death Surveillance and Response Technical Guideline, entered into the EpiData, exported into SPSS for analyses. Odds ratios (ORs) and 95% confidence interval (CI) were computed to determine contributing factors of maternal death and control potential confounding variables. Results About 51 (86%) of all maternal deaths were due to direct obstetric causes. Of this, hemorrhage (45%), hypertensive disorders of pregnancy (23%), and obstructed labor (18%) were the leading direct causes of maternal deaths. Husbands who had no formal education were 5 times higher compared with their counterparts (AOR = 5.1, 95% CI: 1.6–16). Mothers who were not attending ANC were 5 times more at risk for death than those who attend (AOR 5.3, 95% CI 2.3–12.1). Mothers who gave birth at home/on transit were twice to die compared to health facility delivery (AOR 2.6, 95% CI 2.4–6) that were contributing factors of maternal deaths. Conclusions Husband's level of education, lack of antenatal care, and home delivery were the factors contributing to maternal deaths in the zone. Frequent and tailored antenatal care, skilled delivery, and access to education also need due attention.
Leukotriene Involvement in the Insulin Receptor Pathway and Macrophage Profiles in Muscles from Type 1 Diabetic Mice

Type 1 diabetes (T1D) is a metabolic disease associated with systemic low-grade inflammation and macrophage reprogramming. There is evidence that this inflammation depends on the increased systemic levels of leukotriene (LT) B4 found in T1D mice, which shifts macrophages towards the proinflammatory (M1) phenotype. Although T1D can be corrected by insulin administration, over time T1D patients can develop insulin resistance that hinders glycemic control. Here, we sought to investigate the role of leukotrienes (LTs) in a metabolically active tissue such as muscle, focusing on the insulin signaling pathway and muscle-associated macrophage profiles. Type 1 diabetes was induced in the 129/SvE mouse strain by streptozotocin (STZ) in mice deficient in the enzyme responsible for LT synthesis (5LO−/−) and the LT-sufficient wild type (WT). The response to insulin was evaluated by the insulin tolerance test (ITT), insulin concentration by ELISA, and Akt phosphorylation by western blotting. The gene expression levels of the insulin receptor and macrophage markers Stat1, MCP-1, Ym1, Arg1, and IL-6 were evaluated by qPCR, and that of IL-10 by ELISA. We observed that after administration of a single dose of insulin to diabetic mice, the reduction in glycemia was more pronounced in 5LO−/− than in WT mice. When muscle homogenates were analyzed, diabetic 5LO−/− mice showed a higher expression of the insulin receptor gene and higher Akt phosphorylation. Moreover, in muscle homogenates from diabetic 5LO−/− mice, the expression of anti-inflammatory macrophage markers Ym1, Arg1, and IL-10 was increased, and the relative expression of the proinflammatory cytokine IL-6 was reduced compared with WT diabetic mice. These results suggest that LTs have an impact on the insulin receptor signaling pathway and modulate the inflammatory profile of muscle-resident macrophages from T1D mice.
Online Medical Education for Doctors: Identifying Potential Gaps to the Traditional, Face-to-Face Modality

Background: Online education options increasingly complement traditional face-to-face (F2F) approaches. Few studies have compared both formats on doctors, and little evidence exists to prove that the online approach is universally effective. This gap needs to be addressed to ensure that the quality of education and health care delivery is not compromised. Methods: A quantitative survey targeting 881 doctors that required online and F2F teaching sessions offers identical contents over a 12-month period. The surveyed doctors work in the Australian after-hours house-call (AHHC) industry, and the teachings were parts of their continuing professional development activities. Results: In all, 89 responses were received; 10 (11.2%) participated exclusively online, while 23 (25.8%) did so by F2F; 52 (58.4%) engaged through both modalities. No statistical differences existed based on sex, specialty, and post-graduate fellowship status, as well as on the perceptions with teaching structure, contents, and duration of the education programmes. However, F2F-only doctors were likely to be junior and younger than 40 years (odds ratio [OR]: 3.85; P = .01). They also admit easy access to effective teaching environment (OR: 4.07; P = .01) and receive better feedbacks (OR: 3.75; P = .01). Conversely, online-only participants were more likely to combine AHHC duties with regular-hours general practice (OR: 0.15; P = .02) and are generally more satisfied with the programme frequency (OR: 6.90; P = .01). Conclusions: On multiple areas, no differences exist in the medical education delivered by online and the F2F methods to doctors and both should be encouraged. However, younger and junior practitioners, who tend to need feedbacks on their jobs, should participate more in the F2F sessions.
Long‐term evaluation of fitness and demographic effects of a Chinook Salmon supplementation program

While the goal of supplementation programs is to provide positive, population‐level effects for species of conservation concern, these programs can also present an inherent fitness risk when captive‐born individuals are fully integrated into the natural population. In order to evaluate the long‐term effects of a supplementation program and estimate the demographic and phenotypic factors influencing the fitness of a threatened population of Chinook Salmon (Oncorhynchus tshawytscha), we genotyped tissue samples spanning a 19‐year period (1998–2016) to generate pedigrees from adult fish returning to Johnson Creek, Idaho, USA. We expanded upon previous estimates of relative reproductive success (RRS) to include grandparentage analyses and used generalized linear models to determine whether origin (hatchery or natural) or phenotypic traits (timing of arrival to spawning grounds, body length, and age) significantly predicted reproductive success (RS) across multiple years. Our results provide evidence that this supplementation program with 100% natural‐origin broodstock provided a long‐term demographic boost to the population (mean of 4.56 times in the first generation and mean of 2.52 times in the second generation). Overall, when spawning in nature, hatchery‐origin fish demonstrated a trend toward lower RS compared to natural‐origin fish (p < 0.05). However, when hatchery‐origin fish successfully spawned with natural‐origin fish, they had similar RS compared to natural by natural crosses (first‐generation mean hatchery by natural cross RRS = 1.11 females, 1.13 males; second‐generation mean hatchery by natural cross RRS = 1.03 females, 1.08 males). While origin, return year, and body length were significant predictors of fitness for both males and females (p < 0.05), return day was significant for males but not females (p > 0.05). These results indicate that supplementation programs that reduce the potential for genetic adaptation to captivity can be effective at increasing population abundance while limiting long‐term fitness effects on wild populations.
Can social robots help children in healthcare contexts? A scoping review

Objective To review research on social robots to help children in healthcare contexts in order to describe the current state of the literature and explore future directions for research and practice. Design Scoping review. Data sources Engineering Village, IEEE Xplore, Medline, PsycINFO and Scopus databases were searched up until 10 July 2017. Only publications written in English were considered. Identified publications were initially screened by title and abstract, and the full texts of remaining publications were then subsequently screened. Eligibility criteria Publications were included if they were journal articles, conference proceedings or conference proceedings published as monographs that described the conceptualisation, development, testing or evaluation of social robots for use with children with any mental or physical health condition or disability. Publications on autism exclusively, robots for use with children without identified health conditions, physically assistive or mechanical robots, non-physical hardware robots and surgical robots were excluded. Results Seventy-three publications were included in the review, of which 50 included user studies with a range of samples. Most were feasibility studies with small sample sizes, suggesting that the robots were generally accepted. At least 26 different robots were used, with many of these still in development. The most commonly used robot was NAO. The evidence quality was low, with only one randomised controlled trial and a limited number of experimental designs. Conclusions Social robots hold significant promise and potential to help children in healthcare contexts, but higher quality research is required with experimental designs and larger sample sizes.
Adsorption of ethanol molecules on the Al (1 1 1) surface: a molecular dynamic study

The adsorption process of ethanol molecules on Al slabs was investigated by molecular dynamic simulations with a ReaxFF force field. The force field used in this paper has been validated by comparing adsorption energy results with quantum mechanical (QM) calculations. All simulations were performed under the canonical (NVT) ensemble. The single-molecule adsorption simulation shows that the hydroxyl group plays a more important role in the whole progress than the ethyl group. Besides, decomposition of hydroxyl groups was also observed during multimolecule adsorption processes. Simulations of adsorption processes of Al slab by ethanol molecules at different temperatures and pressures (controlled by the number of ethanol molecules) was also performed. System energy and radial distribution function (RDF) plots were invoked to describe adsorption processes and centro-symmetry parameter (CSP) analysis was adopted to study the surface properties with coating layers. Our results indicate that the whole adsorption process can be divided into two periods and the greater the pressure, the more ethanol molecules diffuse into the Al slab. How raising the temperature helps the adsorption processes is related to the initial number of molecules. The crystal structure of the Al surface will become amorphous under the constant impact of ethanol molecules.
Where are the paediatricians? An international survey to understand the global paediatric workforce

Objective Our primary objective was to examine the global paediatric workforce and to better understand geographic differences in the number of paediatricians globally. Secondary objectives were to describe paediatric workforce expectations, who provides children with preventative care and when children transition out of paediatric care. Design Survey of identified paediatric leaders in each country. Setting Paediatric association leaders worldwide. Main outcome measures Paediatrician numbers, provision of primary care for children, age of transition to adult care. Results Responses were obtained from 121 countries (73% of countries approached). The number of paediatricians per 100 000 children ranged from a median of 0.5 (IQR 0.3–1.4) in low-income countries to 72 (IQR 4–118) in high-income countries. Africa and South-East Asia reported the lowest paediatrician density (median of 0.8 paediatricians per 100 000 children, IQR 0.4–2.6 and median of 4, IQR 3–9, respectively) and fewest paediatricians entering the workforce. 82% of countries reported transition to adult care by age 18% and 39% by age 15. Most countries (91%) but only 64% of low-income countries reported provision of paediatric preventative care (p<0.001, Cochran-Armitage trend test). Systems of primary care provision varied widely. A majority of countries (63%) anticipated increases in their paediatric workforce in the next decade. Conclusions Paediatrician density mirrors known inequities in health provider distribution. Fewer paediatricians are entering the workforce in areas with already low paediatrician density, which may exacerbate disparities in child health outcomes. In some regions, children transition to adult care during adolescence, with implications for healthcare training and delivery. Paediatrician roles are heterogeneous worldwide, and country-specific strategies should be used to address inequity in child health provision.
Contemporary follow-up imaging after endovascular repair of lower extremity atherosclerotic lesions

Atherosclerotic disease is currently one of the most important problems of modern medicine because it is a leading cause of increased morbidity, morbidity and mortality, and disability in the Western World. Atherosclerosis of the lower limbs (peripheral arterial disease – PAD) significantly affects the quality of life and in a considerable proportion of patients is a cause of disability. Radical treatment of PAD, both surgical and endovascular, aims at revascularisation of ischaemic tissues distal to obstructed arteries. Surveillance imaging is an important part of patient management after endovascular repair of PAD. Apart from availability and contraindications, challenges of imaging include calcifications, flow dynamics, and stent-related artefacts. The aim of this paper was to review the current literature on imaging methods for follow-up after endovascular repair of atherosclerotic lesions, with special attention paid to novel techniques. As a non-invasive modality, ultrasound is still the first-line examination, but computed tomography angiography remains a current state-of-the art technique for follow-up. However, since current imaging recommendations seem not to adhere to contemporary imaging possibilities, more attention should be paid to recent improvements in magnetic resonance angiography technology.
An audit of studies registered retrospectively with the Clinical Trials Registry of India: A one year analysis

Background: The Clinical Trials Registry of India (CTRI) was launched in July 2007 and will enter its tenth year in 2017. While its mission is to encourage prospective trial registration, CTRI does permit retrospective trial registration. Against this backdrop, the present audit was carried out with the primary objective of assessing the nature and extent of trials retrospectively registered with CTRI. Methods: All studies registered in the year 2016 were searched within CTRI using the keyword “CTRI/2016. ” The total number of trials registered in that year, their phase, the source of funding and their nature (Interventional or observational; whether postgraduate theses or otherwise, source of funding (pharmaceutical industry/Government of India/Institute Funded), whether prospectively or retrospectively registered were noted. We also tested for the association between the nature of the trial and retrospective registration using the Chi-square test and generated crude odds ratios with 95% confidence intervals. Results: A total of 1147 studies were registered in 2016, of which 719 (63%) were retrospectively registered. Interventional studies formed the majority of studies at n = 926 (81%), while postgraduate theses constituted half of the studies (384; 53%). Postgraduate theses (relative to all other studies) were twice as likely to be retrospectively registered (cOR 2.4 [1.8, 3.0], p < 0.0001). Studies funded by the pharmaceutical industry were four times more likely to be registered prospectively relative to nonindustry funded studies (cOR 4.4 [3.2, 5.9], p < 0.0001). Conclusion: Given that CTRI will be insisting on prospective registration effective April 1, 2018, and as trial registration is an ethical, scientific and moral imperative, prospective registration must always be done as prerequisite to participant protection.
High contributions of fossil sources to more volatile organic aerosol

Abstract. Sources of particulate organic carbon (OC) with different volatility have rarely been investigated, despite the significant importance for better understanding of the atmospheric processes of organic aerosols. In this study we develop a radiocarbon-based (14C) approach for source apportionment of more volatile OC (mvOC) and apply to ambient aerosol samples collected in winter in six Chinese megacities. mvOC is isolated by desorbing organic carbon from the filter samples in helium (He) at 200 ∘C in a custom-made aerosol combustion system for 14C analysis. Evaluation of this new isolation method shows that the isolated mvOC amount agrees very well with the OC1 fraction (also desorbed at 200 ∘C in He) measured by a thermal–optical analyzer using the EUSAAR_2 protocol. The mvOC, OC and elemental carbon (EC) of 13 combined PM2.5 samples in six Chinese cities are analyzed for 14C to investigate their sources and formation mechanisms. The relative contribution of fossil sources to mvOC is 59±11 %, consistently larger than the contribution to OC (48±16 %) and smaller than that to EC (73±9 %), despite large differences in fossil contributions in different cities. The average difference in the fossil fractions between mvOC and OC is 13 % (range of 7 %–25 %), similar to that between mvOC and EC (13 %, with a range 4 %–25 %). Secondary OC (SOC) concentrations and sources are modeled based on the 14C-apportioned OC and EC and compared with concentrations and sources of mvOC. SOC concentrations (15.4±9.0 µg m−3) are consistently higher than those of mvOC (3.3±2.2 µg m−3), indicating that only a fraction of SOC is accounted for by the more volatile carbon fraction desorbed at 200 ∘C. The fossil fraction in SOC is 43 % (10 %–70 %), lower than that in mvOC (59 %, with a range of 45 %–78 %). Correlation between mvOC and SOC from nonfossil sources (mvOCnf vs. SOCnf) and from fossil sources (mvOCfossil vs. SOCfossil) is examined to further explore sources and formation processes of mvOC and SOC.