Miracle-dz/UniFAR-FTUs huggingface dataset:
Glioma-associated radiation retinopathy treated successfully with aflibercept

Abstract Radiation retinopathy is a chronic, progressive retinal microangiopathy which can occur with variable latency after retina exposure to ionizing radiation used for cancer treatment. It can occur secondary to treatment of nasopharyngeal tumors, as well as intraocular tumors, such as uveal melanoma and retinoblastoma. Several treatment modalities have been reported including intravitreal corticosteroids, intravitreal anti-VEGFs and argon laser photocoagulation. Our purpose is to present a case report of bilateral radiation retinopathy with macular edema in one eye that was revealed 6 years after glioma therapy and treated successfully by using monotherapy of aflibercept. A 59-year-old male patient presented with gradually deteriorating visual acuity in his left eye for the past 12 months. Best corrected visual acuity in his right eye was 20/25 and in his left eye 20/100. Fundoscopy and fluorescein angiography revealed severe non-proliferative retinopathy in his right eye and proliferative retinopathy in his left eye with macular edema. Following complete work-up and due to his past medical history, he was diagnosed with radiation retinopathy. The patient received 6 intravitreal injections of aflibercept in a period of 9 months in order to treat macular edema and radiation retinopathy. According to the literature, there is minimal experience using aflibercept monotherapy to successfully treat macular edema due to radiation retinopathy. In addition, radiotherapy for glioma is a rather rare cause of radiation retinopathy compared to other more common causes, such as nasopharyngeal tumors, meningiomas, and uveal melanomas.
Prevalence and causes of visual impairment in Saudi children of Arar city

DOI: 10.4328/ACAM.6107 Received: 04.12. 2018 Accepted: 27.12. 2018 Published Online: 28.12. 2018 Printed: 01.11. 2019 Ann Clin Anal Med 2019;10(6): 693-7 Corresponding Author: Mujeeb Ur Rehman Parrey, Ophthalmology, Department of Surgery, Faculty of Medicine, P.O. Box: 1321, Northern Border University, Arar, KSA. T. : 00966504127126 E-Mail: drparrey@gmail.com ORCID ID: https://orcid.org/0000-0002-2731-5438 Abstract Aim: In this study, we aimed to determine the prevalence and main causes of visual impairment (VI) among Saudi children of Arar, the capital city of the Northern Border Region of Saudi Arabia. Material and Method: This population-based cross-sectional study was conducted on 410 Saudi children aged from 6 to 16 years. The examination included visual acuity (VA) testing, ocular motility evaluation, refraction, slit lamp, and fundus examinations. Results: A total of 410 Saudi children aged from 6 to 16 (9.8 ± 2.9 years) were enrolled in the current study; 195 (47.5%) were males and 215 (52.4%) were females. According to WHO classification, VI was diagnosed in 42 (10.2%) cases and 36 (8.7%) cases suffered unilateral diminution of visual acuity (UDoVA). Cases of VI were further classified depending on the severity of VI into mild VI in 34 (8.3%), low vision in 6 (1.4%) and blindness in 2 (0.04%) children. Visual impairment was more common in children aged ≤ 10 years. Refractive error was the most common eye morbidity diagnosed in 167 (40.7%) children of the studied population followed by strabismus in 28 cases (6.8%), then amblyopia in 10 cases (2.4%). Discussion: Visual impairment (VI) in children can have a significant impact on the quality of their life including their performance at school and future employment opportunities. Visual impairment among Saudi children in Arar city is highly prevalent. The leading causes are refractive errors, strabismus and amblyopia. Strategies focused on screening, timely diagnosis and treatment of these causes should help to reduce the burden of childhood VI.
Motor Evoked Potentials in the Upper Extremities of Children with Spastic Hemiplegic Cerebral Palsy

Correspondence to Sung-Hee Park Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea. E-mail: shpark0130@jbnu.ac. kr Da-Sol Kim, Eu-Deum Kim, Gi-Wook Kim, Yu Hui Won, Myoung-Hwan Ko, Jeon-Hwan Seo, Sung-Hee Park Motor Evoked Potentials in the Upper Extremities of Children with Spastic Hemiplegic Cerebral Palsy Brain & NeuroRehabilitation 02
Bayesian inference and model selection for partially observed stochastic epidemics.

Over the past decades, statistical models have been established as an important tool for understanding the transmission dynamics of infectious diseases. Inference in such models can be challenging due to the strong dependencies in the actual epidemic process, as well as the fact that observations often rely in diagnostic tests that have imperfect sensitivities. Moreover, samples are often taken with very low temporal resolution, which leads to the actual dynamics being only partially observed. Data augmentation techniques implemented within the framework of Markov chain Monte Carlo (MCMC) methods can tackle these problems by taking into account the unobserved dynamics of transmission and thus have been widely employed in practice. Despite the methodological advances in the context of partially observed epidemic models, there are still several open challenges that remain to be addressed. One of the key challenges is the establishment of model comparison techniques that can be efficiently applied in problems involving a large amount of missing information. In this thesis, we describe a framework based on importance sampling which provides estimates of the marginal likelihood and is well suited for applications in this complex setting. Until recently, the study of infectious diseases in large scale populations has been challenging due to the computationally intensive methods needed to these models. One further contribution of this thesis is the development of a data augmentation MCMC algorithm that can be used in both Markovian and non-Markovian epidemic models. Our algorithm achieves good computational efficiency and therefore can be viewed as an alternative to existing approaches, particularly for applications on big datasets. The last part of the thesis is concerned with epidemic data containing additional information regarding the strain of a pathogen with which individuals are infected. Quantifying the interactions between the different strains of pathogens is crucial in order to obtain a complete understanding of the disease but statistical methods for this type of problem are still in the early stages of development. Motivated by this demand, we construct a model that incorporates this additional information and propose a statistical algorithm for inference. The model improves upon existing methods in the sense that it allows for both imperfect diagnostic test sensitivities and strain misclassification. Finally, extensive simulation studies are conducted in order to assess the performance of our methods, while the utility of the developed methodologies is demonstrated on data obtained from two longitudinal studies of Escherichia coli in cattle.
Awareness and occupational exposures to needlestick injuries among healthcare workers: A quantitative assessment in a Ghanaian Metropolis

Background: This study determined awareness and occupational exposures to needlestick injuries (NSIs) and its associated risk factors among healthcare workers (HCWs) in the Kumasi Metropolis, Ghana. Materials and Methods: A descriptive cross-sectional study was conducted among a total of 540 HCWs from three selected tertiary hospitals in the Kumasi Metropolis, Ghana. Data were collected using a structured questionnaire and analyzed. Results: All the study participants were aware of NSI and NSI-associated hepatitis B virus (HBV), hepatitis C virus, or human immunodeficiency virus (HIV) acquisition. Most of them (63.6%) were trained on the safety use of sharps devices and the majority of them preferred safety-engineered devices (79.8%). A greater proportion of the participants has had HBV vaccination (85.9%). The prevalence of NSIs was approximately 47%. NSIs were highly ranked to occur at patient’s bedside (28.5%) and clinical laboratories (24.6%). Handling of needles/sharp objects before usage (27.7%) and during usage (34.0%) ranked the second and first cause of NSIs among health workers, respectively. Compared with those with less than 5 years working experience, having worked at the health facility between 5 and 10 years (prevalence rate ration [PRR] = 2.07 [1.39–3.11], p = 0.0004), 11–15 years (PRR = 4.32 [2.14–8.73], p < 0.0001), and >15 years (PRR = 5.73 [2.40–13.70], p < 0.0001) were associated with increased events of NSI. Conclusion: Despite the high awareness of NSIs and its perceived risk of infection acquisition, the prevalence of NSIs was high among HCWs. There is, therefore, the need for employers to enforce the universal precaution practices, provide regular training and education, and ensure adherence of HCWs to safety precaution of needle usage disease.
Impact of Hand Dominance on Effectiveness of Chest Compressions in a Simulated Setting: A Randomised, Crossover Trial

Aim External cardiac compressions (ECC) are a critical component in determining the effectiveness of cardiopulmonary resuscitation (CPR). Guidelines prior to the 2010 International Liaison Committee on Resuscitation directed rescuers to place the heel of the dominant hand directly on the chest when performing ECC, however current guidelines are silent on this issue. Existing research is inconsistent in findings, and heterogeneous in design and participants. The aims of this pilot study were to: 1) investigate the impact of hand dominance on effectiveness of ECC; and 2) generate outcome data to inform sample size calculations for a larger future study. Methods This study utilised a single blinded, prospective randomised crossover trial design. Each participant was allocated to a ‘dominant hand on chest’ (DHOC) or ‘non-dominant hand on chest’ (NDHOC) group. On a simulation manikin, participants in the DHOC group performed 3 minutes of ECC with dominant hand on the chest and non-dominant hand supporting, followed by a ‘rest and recovery’ period and then a second 3-minute period of ECC with the hand reversed such that the non-dominant hand was on the chest. The NDHOC group performed the same series of compressions but in reverse order. The primary outcome measure was effectiveness of ECC, determined by a percentage-based ‘CPR score’ (‘CS’). Secondary outcomes were compression depth, rate and release. The Wilcoxon rank-sum (Mann-Whitney) test was used due to the non-normal distribution of the data. Due to the crossover design, hierarchical linear regression was used to assess for a period or cross over effect. Results For the primary outcome of this study, we have found no significant difference in CS between DHOC and NDHOC (69.9% (SD=29.9) vs. 69.1% (SD=34.1); p=0.92), respectively. There were no differences in the secondary outcomes of compression rate and depth, though compression release was improved in the DHOC group (53% vs. 42%; p=0.02). Conclusion In this randomised crossover study conducted in a simulation context there was no difference in ECC effectiveness measured by an overall effectiveness outcome according to placement of the dominant or non-dominant hand on the chest during compressions. A modest improvement in ECC release was seen in the dominant hand on chest group. While the study was underpowered, the results support an approach involving rescuers placing whichever hand they are most comfortable with on the chest irrespective of handedness.
Feeding Aversion in Children with Neurodisability and its Assessment Using CEBQ: A Tertiary Feeding Clinic Experience

Background: Children with history of prematurity and developmental delay have feeding problems not solely attributed to oropharyngeal structural and motor impairments. Aversion to food and feeding can occur in normal development, but can be severe in various neurodevelopmental syndromes. There is lack of a validated tool to classify and measure the severity of the problem. Objective: The aim of this study was to define the spectrum of aversive feeding behaviours seen in children with neurodisability and assess the usefulness of Child Eating Behaviour Questionnaire (CEBQ) to systemically delineate eating behaviours amongst these children. Methods: This study was done in two phases. In phase one 38 case notes of patients attending the multidisciplinary feeding clinic were analyzed retrospectively for a period of six months. The details of description of their feeding problems, use of antireflux medications and gastrostomy were recorded. In phase two we prospectively used the CEBQ assessment tool on 16 patients showing aversion to food and feeding. Mean sub-domain scores of CEBQ were compared to population norms. Results: In phase one 50% (19/38) patients had feeding difficulties unrelated to oropharyngeal structural or motor problems. The behavioural feeding problems were described as aversion to food and feeding, selective eating, drinking excess fluids, poor oral intake, dislike for solids, disinterest in feeding, slow feeding and aversion for fluids. In phase two 16 patients with aversion to food or feeding and other such behaviours were assessed using CEBQ. Significant group differences in mean CEBQ sub domain scores compared to population norms were noted for food responsiveness (mean CEBQ score 1.75 vs. population mean 2.20), desire to drink (1.92 vs. 2.60), emotional overeating (0.78 vs. 1.90), satiety response (2.5 vs. 3) and enjoyment of food (2.8 vs. 3.5). Subdomain scores were reflective of non-rewarding experience of feeding in this group. Conclusion: This study identifies that feeding difficulties not related to oropharyngeal structural or motor impairment can be complex to assess and manage needing feeding gastrostomy. CEBQ has affirmed non-rewarding experience of feeding in this group and with its limitations can be helpful assessment of feeding aversion. Citation: Kulshrestha R, Dalzell M, Kumar R (2018) Feeding Aversion in Children with Neurodisability and its Assessment Using CEBQ: A Tertiary Feeding Clinic Experience. J Gastroenterol Hepatology Res 3: 017.
Assessment of temperament in children with autism spectrum disorders.

OBJECTIVE To explore the temperament and its correlates in children with autism spectrum disorders. METHODS The cross-sectional study was conducted in Lahore, Pakistan, from February 2015 to June 2016, and comprised children aged 5-11 years diagnosed with autism spectrum disorders selected from different institutes. A detailed demographic questionnaire, Temperament in Middle Childhood questionnaire and Childhood Behaviour questionnaire were administered through in-depth clinical interviews to collect information regarding temperament and significant demographic variables of the subjects. RESULTS Of the 92 subjects, there were 61(66%) boys and 31(34%) girls. Overall mean age was 8.62}1.87 years. The girls had relatively high scores on negative affectivity 19.54 }5.14 (d=0.14) than boys. Whereas, boys scored comparatively higher on surgency 15.81}6.80 (d=0.21) and effortful control 13.69}3.72 (d=0.31) domains of temperament than girls. Negative affectivity shared significant inverse association with cognitive functioning r= - 0.35 (p=0.01). However, surgency r =0.17 and effortful control domains r =0.34 (p=0.01)were positively associated with intellectual functioning. CONCLUSIONS Children with autism spectrum disorders showed a temperament profile different from children following typical development.
Burden and Cost of Rheumatic Fever and Rheumatic Heart Disease in New Zealand: Focus on School Age Children A Report to the Ministry of Health.

Background: Acute rheumatic fever (ARF) is a preventable inflammatory disease which can develop after pharyngitis caused by group A streptococcus (GAS) bacteria. The most severe sequela is rheumatic heart disease (RHD) with mitral and/or atrial valve regurgitation. A school intervention is now available which is likely to reduce the ARF incidence rate by about 60%. In order to achieve value for money it is necessary to target the intervention to the highest risk children. The purposes of this study were: (1) to estimate ARF incidence rates for primary and intermediate school age children by region, ethnicity and socioeconomic deprivation, to inform targetting of the intervention; and (2) to estimate annual costs of ARF and RHD hospital admissions to the NZ Government, to inform a full economic evaluation of a school intervention. Methods: National hospital admissions with a principal diagnosis of ARF or RHD (ICD9_AM 390-398; ICD10-AM I00-I099) for the period January 1993 to December 2009 were obtained from the National Minimum Data Set. Index (first-ever) admissions were stratified by 5-year age group, prioritised ethnicity, (M ori, Pacific, European/Other), NZ deprivation index (NZDep2006) and District Health Board (DHB). The cost of each ARF or RHD admission in the period 2000-2009 was obtained from its diagnosis related group (DRG) cost weight. Deaths with an underlying cause of RHD for the period January 1993 to December 2007 were obtained from the National Mortality Collection. Population denominators were NZ Census prioritised ethnicity.
Role of platelet rich plasma in chronic plantar fasciitis: An outcome analysis

Introduction: plantar fasciitis is most common cause of chronic heel pain. Platelet rich plasma is a new treatment modality that can be beneficial in refractory cases. The purpose of this study is to determine the effectiveness and safety of local PRP injection in plantar fasciitis. Materials and Methods: Thirty-two cases (23 females and 9 males) were treated by local injection of PRP at heel in Arihant Hospital and Research Centre, Indore between October 2016 to September 2017 and followed-up in this prospective study. AOFAS hind foot score and Roles-Maudsley score were used to determine improvement in pain. Results: The mean age of the patients was 45.71±12.1 years (range 23-67 years) and female dominant. Mean duration of symptoms was 11.7±6.7 months (range 6 months to 24 months). Only patients having symptoms for more than 3 months with no relief from conservative treatment were involved in study. The initial mean AOFAS hind foot score, 44.41 ± 3.25 improved to 91.31 ± 7.37 at 9 month follow up, which was statistically significant (p<0.05). The Roles-Maudsley score improved from poor in all the patients to 90.6% patients having good to excellent roles-maudsley score at 9 month follow up. Four patients required a repeat injection at 3 months, from which one patient showed no improvement while rest had significant improvement. Conclusion: local injection of Platelet rich plasma is an effective and safe method in refractory cases of plantar fasciitis.
Influence of Self-Assessment Scripts on Self-Regulated Learning and Students' Performance in a Multimedia Environment

Influence of Self-Assessment Scripts on Self-Regulated Learning and Students’ Performance in a Multimedia Environment by Guillermina Viruet Cruz MA, Interamerican University of Puerto Rico, 1997 BS, Sacred Heart University, Puerto Rico, 1993 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Educational Technology Walden University May 2018 Abstract Multimedia learning may be more effective than text-only methods. Researchers have notMultimedia learning may be more effective than text-only methods. Researchers have not examined the effects of metacognitive strategies on self-regulated learning (SR) within multimedia learning environments (MLE). The purpose of this quasi-experimental study was to examine potential differences in learning and SR skills between students who use a script as a self-assessment tool and students who do not, while creating a conceptual map. The cognitive-affective theory of learning with media was used to frame the study. The sample included 87 secondary school students from a public school in Puerto Rico, enrolled in 11th and 12th grade English courses. Control and treatment groups completed a questionnaire to measure group difference in goal orientations at the beginning of the study. A t-test results indicated differences between the groups in disposition, and motivation variables. SR was measured before and after the implementation process through questionnaires. A 1-way ANOVA showed no differences in SR skills used by both groups. Results showed no differences in learning in both groups. A multiple regression was run to predict learning from group, disposition, and motivation variables. Results indicated the variable group as the most significant predicting the learning process. These results may encourage more research on SR strategies including a focus on different academic content, self-assessment instruments, and variables related to SR in MLE. These findings can contribute to positive social change in guiding teachers, students, and multimedia designers to develop MLE and SR processes to enhance student performance and obtain better academic results. Influence of Self-Assessment Scripts on Self-Regulated Learning and Students’ Performance in a Multimedia Environment by Guillermina Viruet Cruz MA, Interamerican University of Puerto Rico, 1997 BS, Sacred Heart University, Puerto Rico, 1993 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Educational Technology
Micronutrient intake from protein substitutes in patients with phenylketonuria

and Key-Words in Portuguese Introdução: Devido à severidade das restrições dietéticas na PKU, os micronutrientes (MN) podem estar em desequilíbrio. Considerando que a maioria dos substitutos proteicos (SP) é uma fonte bem estabelecida de MN, o nosso objetivo foi analisar a % de adequação de micronutrientes (AM) pelos SP de acordo com as recomendações da EFSA. Metodologia: Uma amostra de 64 doentes com PKU tratados precocemente, com prescrição de SP, que completaram a avaliação anual do estado nutricional em 2018 foi estudada. A média de idades foi 20.6±9.1 (52% mulheres; 1 HPA; 38 PKU moderados; 25 PKU clássicos). 51 doentes estavam sob uma dieta pobre em Phe enquanto 13 estavam com dieta e tratamento de BH4. Foram recolhidos o peso (kg), ingestão de SP (g de equivalente proteico (EP)/dia) e de MN pelos SP e comparados com as recomendações da EFSA. AM deficiente ou excessiva foi considerada quando a ingestão <90% ou> 110%. Resultados: O peso médio dos doentes foi de 54.8±19.4 kg e a mediana da ingestão de EP pelos SP 0.86 g/kg/dia (45.3±18.2 g/dia). Mais de 50% dos doentes excederam a AM para Ca, Fe, Zn, P, I, colina, vitamina A, B1, B2 e B7. Pelo menos 50% dos doentes apresentaram uma AM deficiente para Cu, Se, K, Mg, F, Mn, Mo, vitamina D, E, K, C e B12. Discussão: Uma vez que os SP são prescritos de acordo com as necessidades proteicas, peso, composição dos SP e severidade da doença, vai alterar a ingestão de EP e comprometer a AM. São necessários trabalhos mais robustos de ingestão nutricional na PKU de modo a melhor interpretar o estado de MN nestes doentes. Palavras-chave: Micronutrientes, substitutos proteicos, adequação, fenilcetonúria