Miracle-dz/UniFAR-FTUs huggingface dataset:
Current perspectives and practices of newborn vitamin K administration in low and middle income countries

Background Vitamin K prophylaxis can prevent vitamin K deficiency bleeding (VKDB), and current global recommendations support universal prophylactic use in newborns. Data about access to and use of vitamin K in low and middle income countries (LMIC) are scarce. To address this gap, we explored current perspectives and practices of newborn vitamin K administration in LMIC in order to better understand the barriers to more widespread coverage of this lifesaving preventative treatment. Methods We conducted an online survey of stakeholders involved in newborn health. We sent the survey via e-mail to 109 individuals who were based primarily in LMIC and 23 responses were received, resulting in a response rate of 21%. Respondents were generally health or development professionals from sub-Saharan Africa and Asia. Results Incidence rates at the country level were mostly unknown or not supported by adequate data. Many respondents (17/23) indicated that vitamin K prophylaxis is included in their national newborn care guidelines and policies, while 12 respondents indicated that administration at birth was widely practiced. Around half of respondents reported that health workers were trained in the diagnosis and treatment of VKDB. The most frequently cited barriers to more widespread vitamin K prophylaxis were (in rank order) high rates of home birth (which preclude injections that must be given by skilled health workers), lack of access to and availability of vitamin K, perception that vitamin K prophylactic treatment is not a priority among health workers, lack of vitamin K formulations appropriate for infants, cultural practices suggesting that injection at birth is not acceptable to parents, and vitamin K not being included in national guidelines and policies. There was no consensus as to the ideal formulation, respondents preferring both the current intramuscular (IM) injection and oral formulation. Reported product attributes of IM and oral formulations are summarized. Conclusion Prophylactic administration of vitamin K to newborns is relatively well integrated into policy at the global and country levels, but its practice is underutilized. Barriers to use are access, supply chain logistics, provider attitudes, and restrictions on the use of injections by providers at the community level. Technology innovation may offer some promise to mitigate these barriers, although advocacy and health system strengthening might be more likely to yield improved coverage. Further investigation using in-depth bottleneck analysis at the country level could help identify specific health system improvements.
Caregiver Health Literacy and the Use of Child Health Services

OBJECTIVES. Eighty million US adults have low health literacy, a risk factor for increased health care use among adults. The purpose of this work was to assess the association between caregiver health literacy and the use and cost of child health services. METHODS. We conducted a cross-sectional study of caregiver-child dyads from a sample of children aged 12 months to 12 years presenting to the pediatric emergency department of an urban, public hospital. Caregiver health literacy was measured by the Short Test of Functional Health Literacy in their preferred language (English or Spanish). Child health care use was measured by a 12-month retrospective review of the public hospital system's electronic database and of state Medicaid billing records for 4 types of visits: preventive care, urgent care, emergency care, and hospital care. Cost of child health care use was provided by Medicaid billing records. Multivariate analysis included caregiver education, age, and language proficiency, as well as child age, special health care needs, ethnicity, and health-insurance coverage. RESULTS. A total of 290 dyads were enrolled in the study. Twenty-two percent of caregivers had low (inadequate or marginal) health literacy. Caregivers with low health literacy were more likely to have less than a high school education, to have limited English proficiency, and to have been born outside the United States. There were no differences in health care use or cost between children of caregivers with low health literacy and children of caregivers with adequate health literacy. Three caregiver characteristics were associated with increased use of child health care services: born outside the United States, age at child’s birth <24 years, and limited English proficiency. CONCLUSIONS. One in 5 caregivers of young children has low health literacy. Caregiver health literacy, however, was not associated with disparities in the use of child health services in this inner-city, ethnic minority population.
Cerebral Syphilitic Gumma Misdiagnosed as a Malignant Brain Tumor

Abstract Syphilitic gumma involvement of the central nervous system is extremely rare and frequently misdiagnosed. The authors report a patient of a cerebral syphilitic gumma resembling a malignant brain tumor in a 62-year-old male. He was first suspected of a malignant brain tumor, but the pathological diagnosis was cerebral syphilitic gumma. This patient with unusual findings illustrates the clinical manifestations, imaging, and therapeutic aspects of cerebral syphilitic gumma.
Commitment or control: Patient safety management in Dutch hospitals

Little is known about how to effectively manage healthcare professionals to optimise patient safety. HR-management broadly distinguishes two management approaches that guide employee behaviours: control- and commitment-based management. This qualitative multiple case study aims to explore whether these management approaches are relevant for patient safety management in Dutch hospitals. Whereas the HR-literature describes that organisations focus either on control- or commitment-based management, our results demonstrate that hospitals use a combination of both management approaches. Some hospitals focus more on control-based management, whereas other hospitals emphasise elements of commitment-based management. Once hospitals emphasise commitment-based management, they do not completely abandon control; however, the balance shifts from managerial towards professional control. In addition, the results identified that the combination of management approaches varies within hospitals (e.g., depending on differences in the departments, management positions or job categories), as well as over time (e.g., depending on crisis situations and circumstances that distract hospital’s attention from patient safety).
European Club Football After ‘Five Treatments’ With Financial Fair Play – Time for an Assessment

UEFA’s Club Licensing and Financial Fair Play Regulations (FFP) have impacted European club football. After five distinct applications of the break-even requirement, which represents the cornerstone of these regulations, it is time for an assessment. How has the situation in European top-division football changed since the FFP regulation? The most recent financial data show that European club football is characterized by significant financial recovery and further polarization. How has the FFP regulation presumably affected this development? This article discusses plausible reasons why FFP has contributed to financial recovery but has not aggravated polarization. Understanding the drivers of polarization is essential before taking further regulatory steps.
Prediction of Occult Lymph Node Metastasis by Metabolic Parameters in Patients with Clinically N0 Esophageal Squamous Cell Carcinoma

The aim of this study was to investigate the value of 18F-FDG parameters of the primary tumor in predicting occult lymph node metastasis in patients with clinically N0 esophageal squamous cell carcinoma. Methods: The study comprised 143 consecutive patients (mean age ± SD, 63.9 ± 8.6 y; range, 31.8–81.2 y) from May 2003 to January 2010 who had clinically N0 esophageal squamous cell carcinoma based on preoperative imaging studies including chest CT, 18F-FDG PET/CT, and endoscopic ultrasound. We measured maximum standardized uptake value (SUVmax), mean SUV (SUVmean), total lesion glycolysis (TLG), and metabolic tumor volume (MTV) of the primary tumor and analyzed the relationship between clinicopathologic variables including PET parameters and occult lymph node metastasis using a logistic regression model. Results: Univariate analysis indicated that clinical T classification, SUVmax, SUVmean, MTV, TLG, and longitudinal diameter of tumor were significant risk factors associated with occult lymph node metastasis. Optimal thresholds were cT2–4, SUVmax ≥ 4.8, SUVmean ≥ 3.2, MTV ≥ 5.5 cm3, TLG ≥ 220, and diameter ≥ 3.8 cm. After multivariate analysis, the logistic regression model revealed that clinical T classification (hazard ratio [HR], 4.6; 95% confidence interval [CI], 1.7–12.4; P = 0.003) and SUVmax (HR, 3.5; 95% CI, 1.3–9.2; P = 0.012) were independent risk factors. The combination of SUVmax and clinical T classification (HR, 13.2; 95% CI, 5.4–31.9; P < 0.001) was a significantly better powerful risk factor for occult lymph node metastasis than SUVmax or clinical T classification alone. Sensitivity, specificity, positive predictive value, and negative predictive value of the combination of clinical T classification and SUVmax were 73.0%, 81.5%, 60.0%, and 89.7%, respectively. Conclusion: SUVmax, combined with clinical T classification, may be useful for predicting occult lymph node metastasis in patients with clinically N0 squamous cell carcinoma of the esophagus.
The bile acid‐sequestering resin sevelamer eliminates the acute GLP‐1 stimulatory effect of endogenously released bile acids in patients with type 2 diabetes

Discovery of the specific bile acid receptors farnesoid X receptor (FXR) and Takeda G protein‐coupled receptor 5 (TGR5) in enteroendocrine L cells has prompted research focusing on the impact of bile acids on glucagon‐like peptide‐1 (GLP‐1) secretion and glucose metabolism. The aim of the present study was to assess the GLP‐1 secretory and gluco‐metabolic effects of endogenously released bile, with and without concomitant administration of the bile acid‐sequestering resin, sevelamer, in patients with type 2 diabetes.
Inhibition of acid secretion by electrical acupuncture is mediated via beta-endorphin and somatostatin.

Electroacupuncture (EAP) was shown to inhibit basal gastric acid secretion in dogs and sham feeding-stimulated acid secretion in humans. However, its effect on a meal-stimulated acid secretion in dogs and the mechanisms involved remain unclear. In five dogs prepared with gastric cannulas, gastric acid secretion was determined by a dye-dilution technique for 60 min after intragastric administration of 200 ml of 4% mixed amino acid meal in six different experiments: study 1, no acupuncture; study 2, sham acupuncture (SAP); study 3, EAP; study 4, EAP plus naloxone; study 5, naloxone alone; and study 6, intravenous infusion of somatostatin (SS) and vasoactive intestinal peptide (VIP) at doses of 0.5 and 1.0 micrograms.kg-1.h-1, respectively. EAP was performed on three different points including Pishu, ZusanLi, and Neiguan. Biphasic electrical pulse (25-100 Hz, 12-16 mA) was applied continuously via needles for 75 min starting 15 min before meal. SAP on nonacupoints in hind- and forelegs was performed with the same electrical pulse. Plasma SS, VIP, beta-endorphin, and gastrin were determined by specific radioimmunoassays. EAP significantly inhibited acid secretion (75%; P < 0.01), which coincided with significant increases in plasma SS, VIP, and beta-endorphin and a significant decrease in plasma gastrin. Naloxone completely reversed EAP-induced inhibition of acid secretion and changes in plasma concentration of peptides. SAP also significantly suppressed acid output (30%; P < 0.05), with a modest but significant increase in plasma beta-endorphin. However, the inhibition by EAP on the acid output was significantly greater than that by SAP (P < 0.01). Furthermore, exogenous SS (0.5 microgram.kg-1.h-1) significantly inhibited acid output (78%), whereas VIP failed to inhibit gastric acid secretion. We conclude that, in dogs, EAP significantly inhibits meal-stimulated acid secretion. This acid inhibition is mediated by the release of beta-endorphin and somatostatin, and an endogenous opiate or opiates appear to play an important role in the release of SS, VIP, and beta-endorphin.
Ultrasonography in the evaluation of cold thyroid nodules.

In our catchment area of roughly 1 million inhabitants(tertiary referral centre) a diagnosis of thyroid malig-nancy is made in 20 patients each year. Only about 50%of these patients have a solitary cold thyroid nodulerevealed on scintiscan. The total number of patientsevaluated for a solitary thyroid nodule is 200 each yearand because usually only 10 of these patients proves tohave thyroid malignancy, it is generally believed that therisk of thyroid malignancy in a solitary nodule referredfor diagnostic examination is approximately 2–5%. However, correctly performed epidemiological studies tosubstantiate this have not been undertaken.As diagnosing the few malignant lesions has oftenbeen compared to ‘looking for a needle in a haystack’,thyroid surgery has been the treatment of choice inmost patients in a number of centres (including ours) fora number of years. This has mainly been based onscepticism as to the reliability of ﬁne-needle biopsy as adiagnostic criterion and, considering that the majorityof patients have few or no complaints, has led tosuperﬂuous surgery in the vast majority of patients. It istherefore in the interest of both patients and society, notleast for economic reasons, to achieve better selection ofcandidates for surgery.It has generally been believed that diagnostic imagingcould assist this aim, and imaging of the thyroid(anterior neck) has increasingly been used in the pri-mary evaluation of the thyroid nodule. For a number ofreasons ultrasonography (US) has evolved as the imag-ing modality most often used in most centres. In additionto its low cost, rapid investigation, the aquisition ofdynamic pictures, the possibility of performing guidedbiopsies and punctures, its non-ionizing nature andeasy accessibility, the technique allows determination ofthyroid and nodule size, echo structure (diffuse, uni- ormultinodular), echogenicity (iso-, hyper- or hypoechoicstructures) and evaluation of adjoining neck structures.Indeed, a number of centres use US-guided biopsy as theinitial step in the evaluation of the thyroid nodule,although this remains a matter of debate (1, 2). Fujimoto
Together Alone: An Exploration of the Virtual Event Experience

After 50 years in development, virtual reality (VR) has now become commercially available to consumers. The events industry has started to adopt this transformational technology, by implementing it into live events, or using it as an alternative method for providing event experiences. However, little research attempts to compare real to virtual event experiences to understand perceived user benefits and drawbacks. Using Uses and Gratifications (UG) Theory, this study aims to understand the possible user benefits provided from virtual event experiences. A process was designed that incorporated the viewing of a VR experience that was similar to an event previously attended by respondents. They were then interviewed and performed a Product Reaction Card exercise to compare their experiences. Analysis of the data suggests that current 360 VR technology can be used to extend the experiencescape but not replace live events. Respondents indicate that VR provides emotional gratifications that may build positive associations with event organizations and brands. However, VR in its current form does not provide the social and sensory gratifications of live events. VR can therefore be used to deepen relationships with existing participants or encourage future participation at events.
The benefits of self-compassion and optimism exercises for individuals vulnerable to depression

The effectiveness of two online exercises intended to help individuals experience (1) self-compassion (n = 63) and (2) optimism (n = 55) were compared to a control intervention where participants wrote about an early memory (n = 70). A battery of tests was completed at 1 week following the exercise period, and at 1-, 3-, and 6-month follow-ups. Both active interventions resulted in significant increases in happiness observable at 6 months and significant decreases in depression sustained up to 3 months. The interventions were examined in relationship to dependency and self-criticism, both related to vulnerability to depression. Individuals high in self-criticism became happier at 1 week and at 1 month in the optimism condition in the repeated measures analysis. A sensitivity test using multi-level modeling failed to replicate this effect. More mature levels of dependence (connectedness) were related to improvements in mood up to 6 months in the self-compassion condition. This study suggests that different personality orientations may show greater gains from particular types of positive psychology interventions.
Predictive Factors for Recurrence of Simple Bone Cyst of the Proximal Humerus

Purpose. To evaluate factors predictive of recurrence following curettage of simple bone cysts (SBCs) in the proximal humerus. Methods. Records of 29 male and 3 female patients aged 3 to 22 (mean, 11) years who underwent curettage with or without bone grafting for a solitary SBC in the proximal humerus were reviewed. The appearance, size, location, activity level, and fracture pattern of each cyst were recorded. The cyst index indicated the risk of refracture. Recurrence was defined as a refracture or enlargement of the cyst. Results. 31 patients presented with a pathological fracture. The main symptoms were pain (n=30), loss of function (n=22), and mass/swelling (n=15). 25 patients gave a history of trauma. The duration of symptoms was less than one month. 10 patients had recurrence after a mean of 10 (range, 4–27) months; 5 were refractures and another 5 were enlargement of the cysts. Six were treated conservatively and eventually healed, whereas 4 underwent further curettage. Factors predictive of recurrence were patient age ≤5 years (p=0.014), right-sided cyst (p=0.01), larger cyst (p=0.039), multilocular cyst (p=0.004) and unimpacted fracture (p=0.04). Recurrence was not related to gender, cyst location, or cyst activity level. Conclusion. Most SBCs heal even if the fracture is treated expectantly. SBCs should be left alone unless symptomatic. If curettage is performed, grafts or bone substitutes should be used. More aggressive treatment might be necessary for unimpacted fractures to minimise the risk of recurrence.
Estimating the contribution of occupational solar ultraviolet exposure to skin cancer

Exposure to solar ultraviolet (UV) radiation is the main causative factor for skin cancer. Outdoor workers are at particular risk because they spend long working hours outside, may have little shade available and are bound to take their lunch at their workplace. Despite epidemiological evidence of a doubling in risk of squamous cell carcinoma (SCC) in outdoor workers, the recognition of skin cancer as an occupational disease remains scarce.
Impact of Domain Knowledge on Information Presentation Format Choice: A Cognitive Fit Perspective

Prior research has established the effect of presentation format on decision making performance. However, the effect of domain knowledge on presentation format choice has not been investigated. In the business context, reports are often generated by report designers who lack domain knowledge and the reports are used by decision makers who possess substantial domain knowledge. Drawing from the Cognitive Fit Theory and the domain knowledge and presentation format literature, this study argues that report designers and decision makers have different mental models of the problems and solutions due to differences in their domain knowledge. Hence, we posit that report designers will choose report formats that fit with their own mental models rather than the mental models of the decision makers. The lack of cognitive fit between the mental models and presentation format for the decision makers could lead to sub-optimal performances. Other implications for research and practice have been discussed.
The Effects of Varied Joint Motion and Loading Conditions on Posterior Cruciate Ligament Fiber Length Behavior

Background The posterior cruciate ligament has been described as being composed of 2 bands that reciprocally tighten and loosen with knee flexion, but the fiber anatomy and behavior may be more complex. Hypothesis The mechanical effects of defined loading conditions at discrete knee joint angles can vary significantly within the substance of the posterior cruciate ligament depending on the fiber region tested. Study Design Controlled laboratory study. Methods Nine intact, fresh-frozen cadaveric knees were instrumented with excursion filaments implanted within 4 fiber regions of the posterior cruciate ligament. Patterns of fiber behavior were analyzed as a function of the variable linear separation distance between tibial and femoral fiber attachment sites during joint motion under a simulated quadriceps contraction, tibial internal rotation, and tibial external rotation. Analysis of variance, the Newman-Keuls multiple comparisons procedure, and paired t tests were used to evaluate statistical significance. Results Compared with the control pattern of fiber behavior during unloaded passive knee motion from 0° to 120°, the quadriceps force caused loosening of most ligament fibers at knee flexion of less than 75°. Tibial internal rotation significantly slackened the anterior and central fiber regions near extension and significantly tightened the central and posterior fiber regions with progressive flexion. External rotation had an effect similar to internal rotation on the anterior and central fiber regions but caused significant slackening of the posterior fiber regions from 0° to 45°. Conclusions Distinct geographic regions within the posterior cruciate ligament have different functional roles depending on the joint angle and the type of load to which the knee is subjected. Clinical Relevance The specific graft placement parameters in a given surgical procedure relate to end-to-end length changes of the graft and may have important implications for postoperative rehabilitation and return to specific functional activities.
Credit Allocation Along the Business Cycle: Evidence from the Latest Boom Bust Credit Cycle in Spain

Using a dataset that merges information of loan applications from the Spanish CCR with firms’ financial accounts, we find that during the great recession access to credit of firms with weak balance sheets deteriorated relative to other firms. However, contrary to the financial accelerator theory, we find that during the recovery phase after the latest recession access to credit of weaker firms did not improve relative to other firms and it even further deteriorated somewhat. We also provide empirical evidence that lending policies of banks with firms they are exposed to before the lending decision is taken are comparatively less sensitive to public information than those applied to new firms. This result, together with the positive correlation we find between firms’ access to bank loans and the number of firms’ bank credit relationships, might be linked to the existence of private information developed by banks through their interaction with borrowers. We also find that this relationship lending contributed to smooth credit contraction during the crisis.