Miracle-dz/UniFAR-FTUs huggingface dataset:
Neuropsychiatric and neurodevelopmental outcome of children at age 6 and 7 years who screened positive for language problems at 30 months

We present a prospective study at school age of neuropsychiatric and neurodevelopmental outcome of language delay suspected at child health screening around 30 months of age. In a community sample, 25 children (21 males, 4 females) screening positive and 80 children (38 males, 42 females) screening negative for speech and language problems at age 30 months were examined in detail for language disorders at age 6 years. The screen‐positive children were then followed for another year and underwent in‐depth neuropsychiatric examination by assessors blind to the results of previous testing. Detailed follow‐up results at age 7 years were available for 21 children. Thirteen of these 21 children (62%) had a major neuropsychiatric diagnosis (autism, atypical autism, Asperger's syndrome, attention‐deficit‐hyperactivity disorder [ADHD]), or combinations of these. Two further children (10%) had borderline IQ with no other major diagnosis. We conclude that children in the general population who screen positive for speech and language problems before age 3 years appear to be at very high risk of autism spectrum disorders or ADHD, or both, at 7 years of age. Remaining language problems at age 6 years strongly predict the presence of neuropsychiatric or neurodevelopmental disorders at age 7 years.
Entrepreneurship : a means to poverty reduction in rural northern Ghana?

Poverty has long been a developmental challenge in the Global South in general and in sub-Saharan Africa in particular. Consequently, over recent decades different strategies and programmes such as the Millennium Development Goals have been employed to reduce poverty and to improve the quality of people’s lives. This is very much the case in Ghana, where major strides have towards reducing poverty. Nevertheless, the three northern regions (Northern, Upper East and Upper West) of the country have actually experienced a deteriorating situation with the proportion of people living in poverty increasing. In short, poverty remains an obstacle to development in rural northern Ghana. Significantly, entrepreneurship has been proposed by some as an alternative route to rural poverty alleviation. The purpose of this thesis, therefore, is to examine critically the extent to which communities in rural northern Ghana can become entrepreneurial as a basis for facilitating poverty reduction in the regions. Having contextualised the study within a review of development, poverty and, in particular, entrepreneurship, the thesis explores the entrepreneurial ‘environment’ of rural northern Ghana and the entrepreneurial potential of rural communities in the regions as well as assessing the entrepreneurial human and social capitals possessed by those communities. Overall, this provides a holistic and critical assessment of the opportunities for and barriers to rural entrepreneurship in rural northern Ghana. The study adopts a process of qualitative enquiry, using a multiple-case approach to investigate the problem within broader and distinctive rural locations. Within each case, data were gathered at both district and community levels, employing both focus groups and individual semi-structured interviews. The data collection involved translations and a Translation moderation and mediation process – termed the TMM model – was developed to ensure the quality and rigour of the interview transcripts. The findings from the research conclude that poverty is endemic within the study communities. Nevertheless, it was identified that these communities possess potential human, social, cultural and natural capitals that provide a basis for developing entrepreneurship, as well as opportunities for specific entrepreneurial activities which may contribute to reducing poverty in the communities. However, the research found that limited infrastructure may hinder the entrepreneurial process and, as such, rural entrepreneurship in the communities will be a challenging task. Therefore, for successful rural entrepreneurship in rural northern, infrastructure is a critical issue.
The Effect of Neuraxial Versus General Anesthesia Techniques on Postoperative Quality of Recovery and Analgesia After Abdominal Hysterectomy: A Prospective, Randomized, Controlled Trial

BACKGROUND: Patients undergoing abdominal hysterectomy often have significant postoperative pain despite the use of concurrent multimodal pain strategies. Neuraxial anesthesia has opioid-sparing effects and may provide better postoperative recovery to patients when compared with general anesthesia. Our main objective in this study was to compare the effects of neuraxial and general anesthesia on postoperative quality of recovery after abdominal hysterectomy. METHODS: The study was a prospective, randomized, controlled clinical trial. Seventy healthy females were recruited and randomized to a general anesthesia or neuraxial technique as their primary anesthetic regimen. The primary outcome was the global quality of recovery—40 questionnaire (QoR–40) at 24 hours after the surgical procedure. Other data collected included postoperative pain scores and opioid consumption. Data were analyzed using the Mann–Whitney U test, Fisher's exact test, and linear regression. A P value <0.05 was considered statistically significant. RESULTS: The median difference (95% confidence interval [CI]) in the global QoR–40 score at 24 hours between the neuraxial and general anesthesia groups was 17 (11 to 21.5) (P < 0.001). Patients in the neuraxial anesthesia group had better quality of recovery scores in all the QoR–40 subcomponents than did the general anesthesia group (all P < 0.005). The median difference in global QoR–40 scores at 48 hours between the neuraxial anesthesia and the general anesthesia groups was 8 (6–10) (P < 0.001). Postoperative opioid consumption and pain scores were higher in the general anesthesia group than in the neuraxial anesthesia group. There was an inverse linear relationship between opioid consumption and postoperative quality of recovery at 24 hours, r 2 = 0.67 (P < 0.0001, 95% CI of 0.77 to 0.51), and at 48 hours, r 2 = 0.58 (P < 0.0001, 95% CI of 0.72 to 0.42). CONCLUSION: Neuraxial anesthesia provides better quality of recovery than does general anesthesia for patients undergoing abdominal hysterectomy. The opioid-sparing effects of neuraxial anesthesia were associated with a better quality of recovery in patients after the surgical procedure. In the absence of contraindications, neuraxial anesthesia seems to be a better anesthetic plan for those patients.
Pediatric emergency department walk-outs

The objectives of this study were to determine reasons for leaving a pediatric emergency department before physician evaluation, any adverse outcomes of those leaving, and to assess whether the presence of an ombudsman altered the pattern. This was a prospective follow-up study of all patients who left the pediatric emergency department of the Children's Hospital of Michigan before physician evaluation between October 24, 1991 and January 30, 1992. Information was obtained from medical records and a telephone questionnaire with the parent or guardian one week later. A control group of patients (n=150) evaluated in the same period were randomly selected for comparison and matched for triage acuity score, shift, and weekday/weekend visit. Five hundred and twelve patients left during this period. Contact was made with 82% (419). Forty-three percent of patients left only because of a long wait, and an additional 19% included a long wait as one of the reasons for leaving. There was a significantly longer waiting time for walk-outs compared with controls (188 ± 76.4 vs 93.6 ± 64.9 minutes, P <0.0001). Of the 419 patients followed, 256 (61%) were seen by a physician within seven days, and seven (1.7%) were hospitalized. Three hundred one (72%) were reported to be well; 108 (26%) were better. No deaths occurred. Hospitalization rates were significantly lower for patients who left compared with patients who stayed over the same period of time (7/419 vs 1931/16,990, P <0.0001). The presence of an ombudsman was associated with an increase in walk-outs. We concluded that patients leaving before physician evaluation had longer waiting times than those who stayed. One week later 98% were either well or better. The presence of an ombudsman, intended to be a patient advocate, resulted in more patients leaving before being seen.
THE TRENDS OF TECHNICAL AND ALLOCATIVE EFFICIENCY IN LITHUANIAN FAMILY FARMS

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How to systematically learn lessons from projects: The paradigm of project ReviewsVira Liubchenko

Learning lessons from projects is becoming increasingly critical to organizations and has peaked academics' and practitioners' interests. Although for many reasons in practice, the process of learning today to avoid making the same mistake tomorrow does not necessarily take place throughout the project's lifecycle. This paper is based on research aimed at examining the measurable impact of systematic Lessons Learned, on Project Reviews. Multiple semi-structured interviews were conducted in-depth with project managers working in various industries and with different levels of experience. The focus was on gathering practical savoir-faire and knowledge within projects and understanding their nature, timeframe, barriers and implications for developing a systematic approach for future projects. Generally, the nature of lessons occurring in projects converges from one to another but generate different situational impacts. Despite Lessons Learned being fundamental in avoiding reinventing the wheel, preventing knowledge loss and capitalizing knowledge, literature does not suggest a clear integrated model to help project leaders with theses. Given the nature of systematic Lessons Learned, as explored in this paper, results have shown contradicting practices compared to past studies, regarding realistic timeframes to initiate project learning reviews. Although the knowledge fragmentation paradigm persists in existing, the results validate practical learning paradoxes and attempt to fill the gaps in literature for a greater understanding of how to systematically learn from projects. Ultimately, this paper develops a model to support systematic learning from projects. The research also led to several recommendations to be adopted in order to improve Lessons Learned processes in projects.
Analysis of Longitudinal Clinical Trials with Missing Data Using Multiple Imputation in Conjunction with Robust Regression

Summary In a typical randomized clinical trial, a continuous variable of interest (e.g., bone density) is measured at baseline and fixed postbaseline time points. The resulting longitudinal data, often incomplete due to dropouts and other reasons, are commonly analyzed using parametric likelihood‐based methods that assume multivariate normality of the response vector. If the normality assumption is deemed untenable, then semiparametric methods such as (weighted) generalized estimating equations are considered. We propose an alternate approach in which the missing data problem is tackled using multiple imputation, and each imputed dataset is analyzed using robust regression (M‐estimation; Huber, 1973 , Annals of Statistics 1, 799–821.) to protect against potential non‐normality/outliers in the original or imputed dataset. The robust analysis results from each imputed dataset are combined for overall estimation and inference using either the simple Rubin (1987 , Multiple Imputation for Nonresponse in Surveys, New York: Wiley) method, or the more complex but potentially more accurate Robins and Wang (2000 , Biometrika 87, 113–124.) method. We use simulations to show that our proposed approach performs at least as well as the standard methods under normality, but is notably better under both elliptically symmetric and asymmetric non‐normal distributions. A clinical trial example is used for illustration.
Disparity Detectors in Human Depth Perception: Evidence for Directional Selectivity

Viewing a target moving in depth depresses visual sensitivity to depth when test and adapting stimuli simulate motion along closed paths with the same directions of rotation. However, for opposite directions of rotation, sensitivity is either unaffected or increased. This points to two classes of disparity detectors. Either eye's input to a single class of disparity detector consists of the physiological responses to a single direction of horizontal movement.
Somatotopic organization of inputs from the hand to the spinal gray and cuneate nucleus of monkeys with observations on the cuneate nucleus of humans

Central termination patterns of primary afferents from the hand and forelimb were studied following subdermal injections of HRP conjugates in macaque monkeys. In the middle layers of the dorsal horn of the spinal cord, afferents from digits 1–5 terminated in a rostrocaudal sequence in separate, elongated columns at cervical levels 5–7. Afferents from teh glabrous digits extended to the medial margin of the dorsal gray, while afferents from the dorsal skin of the digits terminated more laterally. Afferents from the dorsal hand and palm terminated lateral to those from the digits, while inputs from the forearm occupied tissue rostral and caudal to the representation of the hand. In the cuneate nucleus, terminations from each digit formed an elongated column that was densely labelled in the central pars rotunda and sparsely labelled in both the rostral and caudal reticular poles. Within the pars rotunda, digits 1–5 were represented in order from lateral to medial. Inputs from the digit tips terminated ventral to inputs from the proximal digits. Afferents from the dorsal skin of the digits terminated in an even more dorsal position, while the most dorsal portion of the pars rotunda related to the glabrous and dorsal hand. Within the pars rotunda, terminations from specific parts of the hand overlapped parcellated clusters of neurons. These clusters were densely reactive for cytochrome oxidase (CO) and were surrounded by myelinated fibers. Much sparser label in the reticular poles was found consistently only after injections in the glabrous digits. Inputs to the poles appeared diffuse and overlapping while preserving some somatotopic order. When treated for CO or stained for Nissl substance or myelin, the pars rotunda of humans showed parcellation patterns that closely resembled the patterns seen in monkeys. From the relationship of inputs to the CO dense cell clusters in monkeys, it was possible to postulate in detail the somatotopic organization of inputs to pars rotunda of humans.
Effects of music listening on stress, anxiety, and sleep quality for sleep-disturbed pregnant women

ABSTRACT Prenatal sleep disturbance has been associated with undesirable birthing outcomes. To determine the effectiveness of listening to music at home in improving sleep quality, 121 Taiwanese pregnant women with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score > 5) were systematically assigned, with a random start to music listening (n = 61) or control (n = 60) group. Participants in the music listening group self-regulated listening to music in addition to receiving general prenatal care similar to that in the control group for 2 weeks. The PSQI and State-Anxiety Inventory were used to assess outcomes. ANCOVA analyses were used with the pretest scores as covariates and showed significant improvement in sleep quality, stress, and anxiety in the music listening group compared with the control group. The most frequently used music genre by participants in the experimental group was lullabies, followed by classical music and crystal baby music. This study supported the theory that 2-week music listening interventions may reduce stress, anxiety, and yield better sleep quality for sleep-disturbed pregnant women. The analysis of participants’ journals also implied that the expectant mothers’ choices of musical genres may correlate more with perceived prenatal benefits or the desire to interact with their unborn child.
Coupling actin flow, adhesion, and morphology in a computational cell motility model

Cell migration is a pervasive process in many biology systems and involves protrusive forces generated by actin polymerization, myosin dependent contractile forces, and force transmission between the cell and the substrate through adhesion sites. Here we develop a computational model for cell motion that uses the phase-field method to solve for the moving boundary with physical membrane properties. It includes a reaction-diffusion model for the actin-myosin machinery and discrete adhesion sites which can be in a “gripping” or “slipping” mode and integrates the adhesion dynamics with the dynamics of the actin filaments, modeled as a viscous network. To test this model, we apply it to fish keratocytes, fast moving cells that maintain their morphology, and show that we are able to reproduce recent experimental results on actin flow and stress patterns. Furthermore, we explore the phase diagram of cell motility by varying myosin II activity and adhesion strength. Our model suggests that the pattern of the actin flow inside the cell, the cell velocity, and the cell morphology are determined by the integration of actin polymerization, myosin contraction, adhesion forces, and membrane forces.
IL-8, IL-12 and IL-10 cytokines generation by neutrophils, fibroblasts and neutrophils- fibroblasts interaction in psoriasis.

PURPOSE Psoriasis is a common skin disease affecting about 1-3% of the world population. Many types of cells, including lymphocytes, dendritics APCs (antigen presenting cells), NKT (natural killer T) cells, neutrophils, keratinocytes and fibroblasts are involved in the pathogenesis of psoriasis.The aim of our study was to assess in psoriatic patients the production of IL-8, IL-10 and IL-12 cytokines by neutrophils, fibroblasts and fibroblasts - neutrophils interaction. MATERIAL/METHODS The production of IL-8, IL-10 and IL-12 cytokines was evaluated in supernatants after cells incubation for 21 h in culture medium alone and in medium in the presence of IL-8 or TNF-α. Concentrations of IL-8, IL-10, IL-12 were measured by enzyme-linked immunosorbent assay (ELISA) method using commercially available kits. RESULTS Our results demonstrate that fibroblasts are not able to produce IL-10 and IL-12 but they generate IL-8. The amount of IL-8 depends on the site of derivation of fibroblasts and on the stimuli. Neutrophils released IL-8, IL-12 (at a lower level in psoriatic patients) and IL-10 but only in the case of healthy donors and at a very low concentration. Moreover, we observed higher concentrations of IL-12 and IL-8 in supernatants as a result of fibroblasts-neutrophils interaction in psoriatic patients. CONCLUSIONS Our results suggest that fibroblasts take part in the inflammatory reaction in psoriasis via cytokines or direct interaction with neutrophils. Fibroblasts probably do not exert any anti-inflammatory effect.
Use of cough sounds for diagnosis and screening of pulmonary disease

Cough sound analysis has attracted interest as a potential low-cost diagnostic tool for low-resource settings, where the burden of pulmonary disease is quite high. However, published results on cough sound analysis are generally limited to specific pulmonary diseases (e.g. detection of Whooping cough — Pertussis) and the study sizes are small. In this paper, we present a general framework for cough sound analysis, which includes automatic cough segmentation, feature extraction and a general classification design that can be applied to a wide range of pulmonary diseases. For our analysis, three evidence-based features were selected (variance, kurtosis, and zero crossing irregularity) as well as an additional feature that we developed (rate of decay). Our cough sound analysis framework was tested using voluntary cough data collected from 54 patients presenting a combination of pulmonary conditions (COPD, asthma, and allergic rhinitis) equally sampled from all patients arriving at a pulmonary clinic, as well as 33 healthy individuals. All study subjects were examined with a stethoscope auscultation, clinical questionnaire, and peak flow meter, and were given a full pulmonary function test (spirometer, body plethysmograph, DLCO), which was the gold standard used to determine each patient's diagnosis. When the classifiers were trained using cough sounds alone, the accuracy (as determined by the AUC of the ROC curve) was 74% for Healthy vs Unhealthy, 80% for Obstructive vs non-Obstructive, and 81% for Asthma vs COPD. We also compared the performance of our cough sound analysis against other low-cost diagnostic tools and observed that cough sounds surprisingly had better performance than lung sound auscultation alone, but had significantly lower performance compared to our clinical questionnaire or peak flow meter test. From these data, we conclude that cough sounds have value as a rapid and simple screening tool, but are of less diagnostic value compared to a clinical questionnaire or peak flow meter.
Diagnosis and Treatment of Low Testosterone among Patients with End‐Stage Renal Disease

The prevalence of low testosterone level is particularly high among patients with end‐stage renal disease (ESRD) and has been associated with mortality. In populations without ESRD, low testosterone level has also been associated with a number of morbidities including cardiovascular disease, diabetes mellitus, low muscle mass, low bone mass, low physical performance, and frailty. However, there is controversy regarding what constitutes low testosterone level in the aging population and at what level replacement therapy with testosterone is indicated. There are no randomized controlled trials investigating long‐term outcomes of testosterone replacement therapy in populations with or without ESRD. Available trial results suggest equivocal improvements in sexual function. Muscle mass and bone mineral density appear to improve, but results in physical function and performance are mixed and there are no data on fracture prevention. Some recent data suggest harm when testosterone was given to men with limited mobility. Finally, there is little evidence that testosterone adds to existing erythropoietin agents in the treatment of anemia in ESRD. Due to lack of evidence supporting long‐term use of testosterone, the authors recommend against the routine use of testosterone in ESRD patients with low testosterone levels. Testosterone treatment can be considered in those with low bone mass and total testosterone level <200 ng/dl, or in younger patients with sexual complaints with total testosterone level lower than the reference range. It is important to engage patients in discussion of risks and benefits before initiating testosterone therapy; testosterone therapy should be discontinued if the intended treatment effect is not observed after short‐term use.