Miracle-dz/UniFAR-FTUs huggingface dataset:
Wellbeing and mental health amongst medical students in Jordan: a descriptive study

Abstract Across the globe medical students are experiencing high levels of depression, anxiety, and psychological distress. This can ultimately lead to poor academic performance, substance misuse and/or concerns over clinical practice and fitness to practice. We surveyed Jordanian medical students to assess burnout (using the Oldenburg Burnout Inventory, OLBI), minor psychiatric illness (General Health Questionnaire 12, GHQ12) and alcohol/substance abuse (CAGE questionnaire). Results indicate a high level of exhaustion (91%), disengagement (87%) and ‘minor’ psychiatric illness (92%). OLBI and GHQ12 scores were found to correlate positively (p < 0.001). The CAGE questionnaire was positive in 8% of students. Further research is required to confirm these results and compare them to the global burden of mental illness in medical students. Medical students in Jordan should be considered a high-risk group for burnout and mental health problems and strategies should be employed to recognise and appropriately manage those most at risk.
Highly diverse anaerobe-predominant vaginal microbiota among HIV-infected pregnant women in Zambia

Vaginal dysbiosis has been shown to increase the risk of some adverse birth outcomes. HIV infection may be associated with shifts in the vaginal microbiome. We characterized microbial communities in vaginal swabs collected between 16–20 gestational weeks in the Zambian Preterm Birth Prevention Study to investigate whether HIV and its treatment alter the microbiome in pregnancy. We quantified relative abundance and diversity of bacterial taxa by whole-genome shotgun sequencing and identified community state types (CST) by hierarchical clustering. Associations between exposures—HIV serostatus (HIV+ vs HIV-) and preconceptional ART (ART+ vs ART-)—and microbiome characteristics were tested with rank-sum, and by linear and logistic regression, accounting for sampling by inverse-probability weighting. Of 261 vaginal swabs, 256 (98%) had evaluable sequences; 98 (38%) were from HIV+ participants, 55 (56%) of whom had preconceptional ART exposure. Major CSTs were dominated by: L. crispatus (CST 1; 17%), L. ] iners (CST 3; 32%), Gardnerella vaginalis (CST 4-I; 37%), G. vaginalis & Atopobium vaginae (CST 4-II; 5%), and other mixed anaerobes (CST 4-III; 9%). G. vaginalis was present in 95%; mean relative abundance was higher in HIV+ (0.46±0.29) compared to HIV- participants (0.35±0.33; rank-sum p = .01). Shannon diversity was higher in HIV+/ART+ (coeff 0.17; 95%CI (0.01,0.33), p = . 04) and HIV+/ART- (coeff 0.37; 95%CI (0.19,0.55), p < . 001) participants compared to HIV-. Anaerobe-dominant CSTs were more prevalent in HIV+/ART+ (63%, AOR 3.11; 95%CI: 1.48,6.55, p = .003) and HIV+/ART- (85%, AOR 7.59; 95%CI (2.80,20.6), p < . 001) compared to HIV- (45%). Restricting the comparison to 111 women in either CST 3 (L. iners dominance) or CST 1 (L. crispatus dominance), CST 3 frequency was similar in HIV- (63%) and HIV+/ART- participants (67%, AOR 1.31; 95%CI: (0.25,6.90), p = . 7), but higher in HIV+/ART+ (89%, AOR 6.44; 95%CI: (1.12,37.0), p = . 04). Pregnant women in Zambia, particularly those with HIV, had diverse anaerobe-dominant vaginal microbiota.
Commercially available bone graft substitutes: the impact of origin and processing on graft functionality

Abstract Development of effective and cost-efficient bone tissue engineering grafts has been the key area of research for regenerative medicine, yet an ideal grafting material has remained elusive due in large part to the highly dynamic nature of bone. A wide array of materials, both natural and synthetic, have been implemented as potential candidates for commercially available products, yet the gold standard for grafting material still remains autogenous bone. We review currently commercially available bone graft materials and relevant graft characteristics that impact the effectiveness of tissue repair, emphasizing the advantages and disadvantages of materials based on composition and origin. Examined materials were selected through a web-based search for readily accessible and clinically applicable graft materials. Grafts were then categorized according to material source to examine advantages and disadvantages associated with allogenic, xenogeneic, synthetic materials. Lastly, the application of bioactive molecules onto these basal grafts is explored to illustrate the enhancement and regulative capacity of these additives on traditional osteobiologic materials.
Posttransplant Outcomes for cPRA-100% Recipients Under the New Kidney Allocation System

Background. There is concern in the transplant community that outcomes for the most highly sensitized recipients might be poor under Kidney Allocation System (KAS) high prioritization. Methods. To study this, we compared posttransplant outcomes of 525 pre-KAS (December 4, 2009, to December 3, 2014) calculated panel-reactive antibodies (cPRA)-100% recipients to 3026 post-KAS (December 4, 2014, to December 3, 2017) cPRA-100% recipients using SRTR data. We compared mortality and death-censored graft survival using Cox regression, acute rejection, and delayed graft function (DGF) using logistic regression, and length of stay (LOS) using negative binomial regression. Results. Compared with pre-KAS recipients, post-KAS recipients were allocated kidneys with lower Kidney Donor Profile Index (median 30% versus 35%, P < 0.001) but longer cold ischemic time (CIT) (median 21.0 h versus 18.6 h, P < 0.001). Compared with pre-KAS cPRA-100% recipients, those post-KAS had higher 3-year patient survival (93.6% versus 91.4%, P = 0.04) and 3-year death-censored graft survival (93.7% versus 90.6%, P = 0.005). The incidence of DGF (29.3% versus 29.2%, P = 0.9), acute rejection (11.2% versus 11.7%, P = 0.8), and median LOS (5 d versus 5d, P = 0.2) were similar between pre-KAS and post-KAS recipients. After accounting for secular trends and adjusting for recipient characteristics, post-KAS recipients had no difference in mortality (adjusted hazard ratio [aHR]: 0.861.623.06, P = 0.1), death-censored graft failure (aHR: 0.521.001.91, P > 0.9), DGF (adjusted odds ratio [aOR]: 0.580.861.27, P = 0.4), acute rejection (aOR: 0.610.941.43, P = 0.8), and LOS (adjusted LOS ratio: 0.981.161.36, P = 0.08). Conclusions. We did not find any statistically significant worsening of outcomes for cPRA-100% recipients under KAS, although longer-term monitoring of posttransplant mortality is warranted.
Editorial Comment.

This study has inherent design limitations and significantly better results than previous studies of SNM. There is no placebo or other comparison treatment arm (medical therapy or pelvic floor therapy), which would have made the study findings more powerful and relevant. There is a well-known placebo effect in patients with voiding dysfunction, especially early on. This study could have controlled that issue with a delayed group which was implanted but in which the device was not initially turned on to serve as a comparison group. The response rate in this study is significantly higher than in other SNM studies, such as the MDT-103 trial. This may be due to a combination of experienced implanters, careful patient selection, response definition and evaluation, and perhaps device related factors. Even in experienced hands the response rate using other SNM systems has been at best in the 60% to 70% range (reference 5 in article). Whether the response rate will stay at the 90% level at 2 or 5 years in this group of patients and whether the response rate will be reproducible in the hands of general urologists or urogynecologists remains an open question. To our knowledge the cost of this rechargeable system is currently unknown. However, if this system is competitively priced, maintains a 60% to 70% response rate for more than 7 years and lasts the claimed life of 15 years, it represents a significant advance over current systems. Hopefully these conditions are met and will result in cost savings to the United States health care system.
SERUM cardiac‐specific biomarkers and atrial fibrillation in myotonic dystrophy type I

The aim of the present study was to evaluate the role of high‐sensitivity cardiac troponin I, N terminal pro‐B‐type natriuretic peptide (NT‐proBNP), creatine kinase‐MB mass concentration (CK‐MB mass) and copeptin (CP) in predicting incident atrial fibrillation (AF) in myotonic dystrophy type 1 (DM1) patients.
Toward the Development of a Culturally Humble Intervention to Improve Glycemic Control and Quality of Life among Adolescents with Type-1 Diabetes and Their Families

Abstract Type-1 Diabetes (T1D) is a prevalent and costly disorder associated with substantial morbidity that differentially impacts low-income and/or minority adolescents and their families. The primary study objective was to develop a guiding model to inform culturally humble interventions for Mid-southern youth with T1D presenting with multiple correlates of suboptimal glycemic control and their families. In order to develop a clinic specific guiding model, conceptualizations of health, the need/type of intervention thought to be most helpful, the optimal structure, and strategies to improve the cultural/regional fit was ascertained from (A) youth with T1D (n = 13) and caregivers (n = 11) via qualitative interviews and, (B) pediatric endocrinologists and nurse practitioners (n = 6), and (C) nurses, diabetes educators, dietitians, and social workers (n = 9) via focus groups. Qualitative themes were synthesized to guide the treatment development model whereby Quality of Life and Glycemic Control would be directly enhanced by interventions to promote Coping, Support, Education, and Improved Psychosocial Functioning and indirectly through improved Adherence and T1D Autonomy delivered in a culturally humble way that affirms youths’ T1D identify. These finding suggest that existing evidence-based treatments may provide a great fit for low-income, and/or minority youth with T1D and their families living in the mid-south, provided these interventions are delivered in culturally humble manner.
Prevalence and Correlates of Past-Year Recovery From DSM-5 Alcohol Use Disorder: Results From National Epidemiologic Survey on Alcohol and Related Conditions-III.

BACKGROUND Little is known about remission, recovery, and other outcomes of alcohol use disorder (AUD) as defined by the DSM-5. METHODS Data from a large representative sample of the United States was used to examine correlates of past-year AUD status among individuals with prior-to-past-year AUD: persistent AUD, symptomatic high-risk drinking, asymptomatic high-risk drinking, symptomatic low-risk drinking, asymptomatic low-risk drinking (nonabstinent recovery, NAR), and abstainer (abstinent recovery, AR). Multiple logistic regression analyses were conducted to compare: (i) AR and NAR with persistent AUD, (ii) AR with NAR, and (iii) asymptomatic and symptomatic high-risk drinking with AR and NAR. RESULTS Among individuals with AUD prior to past year (n = 7,785), 34.2% were classified with persistent AUD, 8.8 and 1.6% were symptomatic high-risk and symptomatic low-risk drinkers, respectively, 21.5% were asymptomatic low-risk drinkers, 17.9% were asymptomatic low-risk drinkers, and 16.0% were abstainers. One-quarter of individuals with AUD prior to past year achieved AR or NAR without the benefit of treatment, while a much greater percentage of individuals achieving AR (43.2%) reported receiving treatment relative to those with NAR (12.3%). The number of lifetime AUD symptoms was greater among those achieving AR (among the treated) and lower among those achieving NAR relative to persistent AUD. The number of AUD symptoms was also greater among those achieving AR than NAR and lower among asymptomatic and symptomatic risk drinkers relative to those achieving AR and NAR. Consumption was greater among those achieving AR relative to those achieving NAR and greater among asymptomatic and symptomatic risk drinkers relative to AR and NAR. Odds of achieving AR or NAR relative to persistent AUD were generally lower among non-Hispanic Blacks and those with higher education, greater among women and married individuals, and lower among illicit drug users and individuals with histories of a personality disorder or mood/anxiety disorder. CONCLUSIONS There appears to be substantial level of recovery from AUD. Information on specific factors associated with AUD outcomes can be useful in targeting appropriate treatment efforts.
Risk Factors for Prolonged Air Leak After Pulmonary Resection: A Systematic Review and Meta-Analysis.

OBJECTIVE The aim of this study was to identify risk factors for prolonged air leak (PAL) after pulmonary resection and summarize the quality of evidence. SUMMARY BACKGROUND DATA PAL frequently complicates recovery after pulmonary resection. Studies examining risk factors for PAL are highly variable in study population, design, and findings. METHODS We searched MEDLINE and EMBASE from database inception to December 31, 2017; studies reporting on risk factor (s) for PAL after pulmonary resection for malignant or benign pathology were included. Data on study characteristics, quality, and outcomes were extracted. Study quality and quality of evidence supporting risk factors were rated. Previous significance of risk factors was summarized. For the meta-analysis, pooled odd ratios or mean difference and I heterogeneity were calculated using a random-effects model. RESULTS The systematic review included 37 studies, whereas 26 studies provided data for the meta-analysis, including 37,118 lung resections; 3546 had PAL occurrence. After meta-analysis, 17 risk factors were found to be significant; based on larger effect size, non-significant heterogeneity, and at least low quality of evidence or higher, the most strongly associated with PAL were forced expiratory volume in 1 second percent of predicted [mean difference = 8.84; 95% confidence interval (CI), 7.27-10.42], previous smoking history [odds ratio (OR) = 2.05; 95% CI, 1.63-2.58], major anatomic lung resection (OR = 2.82; 95% CI, 2.36-3.37), and pleural adhesions (OR = 1.94; 95% CI, 1.77-2.12). Modified GRADE quality of evidence was low or very low for the majority of risk factors. CONCLUSION A large number of perioperative factors are associated with PAL. Our review can guide risk-reducing interventions, clinical prediction rules, and patient-specific treatment and management strategies for PAL.
Scientific rationale of antifungal drug combination, including oral itraconazole and terbinafine, in recalcitrant dermatophytoses

Recalcitrant dermatophytoses is becoming increasingly prevalent due to increasing microbiological resistance and clinical failures reported to terbinafine. Recently, a paper has been published by Priyanka Sharma [1] in this journal showing clinical and mycological cure achieved in 90% of the patients receiving combination of itraconazole and terbinafine. This is a correspondence in reply to the above article to highlight the pharmacological and microbiological irrationality of the use of these two drugs in a combination therapy.
Cold temperature improves tannin tolerance in a granivorous rodent.

1.The foraging ecology of mammalian herbivores is regulated in part by their ability to detoxify plant secondary metabolites (PSM). Ambient temperature has been shown to alter liver function in rodents and the toxicity of some PSMs, but little is known about the physiological and nutritional consequences of consuming PSMs at different ambient temperatures. Furthermore, the effect of ambient temperature on the response of mammals to the most ubiquitous class of PSM, tannins, is unknown. 2.We measured the effect of temperature and tannin intake on liver function, and the subsequent effect on the tannin tolerance of wild Japanese wood mice, Apodemus speciosus. The experiment involved acclimation to one of two ambient temperatures (10 °C or 20 °C) followed by acclimation to a diet of acorns (6.2 % tannin DW). Liver function was measured both before and after acclimation to acorns by measuring the clearance time of a hypnotic agent. Finally, the mice were fed only acorns in a 5-day feeding experiment to assess their tolerance to tannin in the diet. 3.Acclimation to acorns had a significant effect on liver function, but the direction of this effect was dependent on ambient temperature. Acorn consumption improved the liver function of wood mice at 10 °C, but reduced liver function at 20 °C, revealing a complex relationship between ambient temperature and tannin intake on liver function. Furthermore, mice with better liver function, indicated by faster clearance of the hypnotic agent, exhibited higher protein digestibility on an acorn-only diet, indicative of higher tannin tolerance. 4.These results suggest that environmental temperature plays a significant role in the tolerance of A. speciosus to tannins, providing new insight in to their seasonal feeding behavior and winter ecology. We contend that cold-induced tannin tolerance may help to explain the population dynamics of mammalian herbivores with seasonal changes in the tannin content of their diet, and inform predictions about the response of these animals to a changing climate.
POLYPHARMACY ASSOCIATED WITH COGNITIVE FRAILTY IN THE ELDERLY ? RESULTS FROM THE KOREAN FRAILTY AND AGING COHORT STUDY

Objectives: Cognitive frailty—the coexistence of physical frailty and cognitive impairment—is a phenotype of frailty in the elderly. The coexistence of physical frailty and cognitive impairment, known as cognitive frailty, is one of the phenotypes of frailty in the elderly. Cognitive frailty predicts adverse health outcome more accurately than does physical frailty. In this study, we aim to determine whether the polypharmacy common among the elderly is linked with cognitive frailty. Design, Setting, and Participants: The elderly, aged between 70 and 84 years, who participated in the cross-sectional Korean Frailty and Aging Cohort Study were included in the present study. Measurements: Polypharmacy and hyperpolypharmacy were defined as the use of at least five and ten medications, respectively. Physical frailty was assessed by the Korean version of the FRAIL scale, and cognitive status was measured by the Trail Making Test part A, word list recall test, the Korean version of the Frontal Assessment Battery, and the Digit Span Backward test. Results: Among the 2,392 participants, 26.8% and 4.1% took more than five and ten prescribed medications, respectively. Polypharmacy and hyperpolypharmacy participants tend to have more cognitive impairment and physical frailty. Participants with cognitive frailty had the highest polypharmacy rate regardless of medication type. After controlling for the potential confounders including severity of comorbidities, frailty was found to be significantly related to polypharmacy, as defined by prescribed as well as total medications, including non-prescribed medications. However, cognitive impairment only showed a linkage to polypharmacy of prescribed medications, which— according to the results of multivariable analysis— could increase cognitive frailty, with an odds ratio of 2.70. Conclusion: Although the elderly tend to depend on various medications, they should seriously consider the risk of polypharmacy for better health outcomes.
Research and development of IMU sensors-based approach for sign language gesture recognition

This paper discusses a few Inertial Measurement Unit (IMU) sensor-based approaches for sign language gesture recognition. Generally, there are three main research areas for the IMU sensor-based approach which consist of the device structure, sensors fusion algorithm and calibration method, and finally gesture recognition and classification method. The device structure includes the number and placement of the sensors to cover the degrees of freedom. Sensors fusion algorithms, such as complementary filter, Kalman filter, and EKF are implemented to combine a variety of sensors used for data acquisition. Several gesture classification and recognition methods are also reviewed in this paper. Some of the limitations related to sensor-based technique such as device structure and classification technique are discussed as a research gap for future references.
Joint Scheduling and Channel Allocation for End-to-End Delay Minimization in Industrial WirelessHART Networks

WirelessHART is one of the most widely used communication standards in industrial wireless networks. In order to meet the stringent real-time requirements in industrial applications, WirelessHART incorporates many designs including the time slotted channel hopping mechanism that enables dynamic time scheduling and channel allocation. In this paper, we study the problem of joint transmission scheduling and channel allocation aiming to minimize the end-to-end delay of multiple flows in multihop WirelessHART networks. We propose a new network model based on a multidimensional scheduling space spanned by flow-link-channel-slot tuples. A multidimensional conflict graph is then established to depict the conflict relationships among the tuples. Based on this, the original delay minimization problem is formulated as an integer program, which however is difficult to solve due to its significantly large scale. To this end, we develop an iterative hop-wise scheduling algorithm by transforming the original problem into a series of maximum weighted independent set problems. We derive theoretical analysis on the schedulability and the performance bound of the proposed algorithm. In addition, we show that our results can be easily extended to accommodate more general scenarios. Finally, extensive simulation results are provided to demonstrate the effectiveness of the algorithm.
Influential Attribute Community Search

Community search in node-attributed network has attracted extensive attention. But, most of previous researches ignore the influence among nodes. This lead to inaccuracy in many scenes where it requires communities with high expansibility. Some researches may consider the influence in community search, but they ignore the attributes cohesion of community. In this paper, we study community search problem and propose an influential attribute community search method based on both influence and attribute features. Our method can find the attributed pk-truss community with largest attribute and influence relevance score function. Most of the community models adopt k-core or k-clique. But k-core has weaker structural tightness than that of k-truss, and k-clique has a strong rule and high computation complexity. So in our method, we first present attributed pk-truss community model based on k-truss. Then we propose a novel score function to check the cohesion of the community. This function can consider both the influence features and attribute features of the community. So it can improve the accuracy of searching results. Besides, to conduct influential attribute community search in large network, our method introduces graph refining method. Experiments on two large networks with ground-truth communities show the quality evaluation, effectiveness and efficiency of our proposed method.