Miracle-dz/UniFAR-FTUs huggingface dataset:
Crossing the transition chasm: experiences and recommendations for improving transitional care of young adults, parents and providers.

BACKGROUND Transition from paediatric to adult healthcare has received little attention in the Netherlands. This study aimed to: (i) map experiences with the transfer to adult care of young adults with chronic conditions; and (ii) identify recommendations for transitional care of young adults, their parents and healthcare providers. METHODS Semi-structured interviews with 24 young adults after transfer (aged 15-22 years; diagnosed with haemophilia, diabetes mellitus, spina bifida, congenital heart disorders, cystic fibrosis, juvenile rheumatoid arthritis or sickle cell disease), 24 parents and 17 healthcare providers. Thematic analysis was performed. RESULTS Only the haemophilia department offered a structured transition programme, most patients had not been prepared for transition. Experiences and views of patients, parents and professionals mainly overlapped and were condensed into four core themes. Two are related to moving to adult care: (1) 'leaving paediatric care is a logical step'. Leaving familiar surroundings was harder for parents than for young adults who displayed a positive 'wait-and-see' attitude; and (2) 'transition is complicated by cultural gaps between paediatric and adult services'. Young adults and parents felt lost after transfer and recommended their peers 'to be alert and involved'. Providers also recognized the cultural chasm between both services and worried about non-compliance, lost to follow-up and lack of independence. Two other themes indicated priorities for improvement: (3) 'better patient and parent preparation' for differences between healthcare settings and for new roles and responsibilities with respect to self-management; and (4) 'more collaboration and personal links' between paediatric and adult care providers. CONCLUSIONS Action is required to cross the chasm between paediatric and adult-oriented care. Preparation for transition should start early and focus on strengthening adolescents' independency without undermining parental involvement. Building bridges between services, gaining trust and investing in new personal relations is a challenge for all parties involved: transition is about responding and bonding.
The link between information and communication technologies and global public health: pushing forward.

Global public health (GPH) continues to be a challenging field. It focuses on health-related issues that transcend national boundaries and thus requires global cooperation for implementing solutions to public health problems. Information and communication technologies (ICTs) have the potential to contribute to GPH by improving the quality of healthcare services. The purpose of this commentary article is to discuss the nature and characteristics of the existing link between ICTs and GPH. The key underlying questions discussed in this article are (a) whether ICTs can truly reduce the burden of current GPH problems and (b) how to effectively achieve it. We selected three widely recognized GPH challenges: diarrheal disease among children under 5 years old, malaria, and type 2 diabetes mellitus. These are considered to be examples of salient global issues that, despite the availability of cost-effective preventive and therapeutic interventions, still remain a major burden of morbidity and mortality worldwide. We conclude that there is a growing global interest in ICT-related solutions in GPH. We recommend the development of more transparent frameworks, more theory-informed solutions, and clearer translational links between ICTs and GPH matters. Ten further specific recommendations are also discussed in this article.
Mixed-genotype infections of the rodent malaria Plasmodium chabaudi are more infectious to mosquitoes than single-genotype infections

Interactions between parasite genotypes sharing a host are poorly understood, but have important consequences for the epidemiology and evolution of the parasite. In mixed-genotype malaria infections, patterns of asexual replication and transmission favoured by natural selection may be different from those in single-genotype infections. The infectivity to mosquitoes of mixed-genotype and single-genotype infections were compared using 2 clones of Plasmodium chabaudi inoculated into mice either together or alone. Mice given mixed-clone infections received the sum of the inocula given to the single-clone controls. Mosquitoes were fed on the mice and the numbers of oocysts which developed were counted to assess transmission intensity. For 3 combinations of starting inocula and feed days, mixed-clone infections produced more oocysts per mosquito than the sum of the 2 single-clone infections. This effect was correlated with an increase in gametocyte density, but was less clearly related to asexual infection parameters. The results show that interactions between clones in mixed-clone infections can profoundly affect transmission.
Studies on the prolactin response induced by electroconvulsive therapy in schizophrenics

Electroconvulsive therapy (ECT) and simulated ECT (SECT)‐induced prolactin response has been studied in 14 schizophrenic males. Cortisol, growth hormone, and thyroid stimulating hormone (TSH) changes have been measured simultaneously. The prolactin rise was significantly higher after ECT than after SECT. Cortisol increase after ECT did not exceed significantly the elevation after SECT. Changes in growth hormone and TSH concentrations were inconsistent and non‐significant. On the basis of the results it may be assumed that ECT‐induced prolactin response is a consequence of specific transmitter changes in the CNS and not a result of stress reaction or generalized neuronal discharge. ECT‐induced prolactin response was negligible in two cases. Both patients were chronically hospitalized schizophrenics resistant to therapy. Whether the prolactin response or its absence is of predictive value with respect to prognosis or effect of ECT remains to be seen.
Grand unification of neutron stars

The last decade has shown us that the observational properties of neutron stars are remarkably diverse. From magnetars to rotating radio transients, from radio pulsars to isolated neutron stars, from central compact objects to millisecond pulsars, observational manifestations of neutron stars are surprisingly varied, with most properties totally unpredicted. The challenge is to establish an overarching physical theory of neutron stars and their birth properties that can explain this great diversity. Here I survey the disparate neutron stars classes, describe their properties, and highlight results made possible by the Chandra X-Ray Observatory, in celebration of its 10th anniversary. Finally, I describe the current status of efforts at physical “grand unification” of this wealth of observational phenomena, and comment on possibilities for Chandra’s next decade in this field.
A qualitative study of sexual behavior change and risk compensation following adult male circumcision in urban Swaziland

Male circumcision has been shown to reduce the risk of heterosexual transmission of HIV infection in men by up to 60% in three randomized controlled trials. Less is known, however, about sexual behavior change in men who have been circumcised and whether male circumcision's protective effect leads to riskier sexual behaviors. This study used qualitative in-depth interviews to understand men's sexual behavior after circumcision and to determine whether and how men participated in riskier sexual behaviors following male circumcision. Men in urban Swaziland, circumcised in the previous 12 months, were recruited and asked about their perceptions of sexual risk and sexual behavior post-circumcision. Results showed that following circumcision, men experience changes in both their sexual attitudes and behavior, which can be considered both protective and risky for HIV transmission. Most of them described protective changes (e.g., more responsible attitudes towards safe sex, reducing sexual temptation and partners, easier condom use). A minority, however, experienced increased sexual risk-taking, typically during a brief period of sexual experimentation shortly after circumcision. HIV counseling and counseling throughout the circumcision process is shown to be critical in influencing protective behaviors. Findings in this study confirm the existence of risk compensation following circumcision; however, this study adds important contextual insight about precisely when and why such risk-taking occurs. Nevertheless this study suggests that male circumcision scale-up as an HIV prevention strategy is likely to foster protective behavior change among men. The integration of HIV counseling with circumcision provision remains critical for effectively mitigating HIV risk behavior as male circumcision gains momentum as a viable HIV prevention tool.
Classification of breast lesions using segmented quantitative ultrasound maps of homodyned K distribution parameters.

PURPOSE Statistical modeling of an ultrasound backscattered echo envelope is used for tissue characterization. However, in the presence of complex structures within the analyzed area, estimation of parameters is disturbed and unreliable, e.g., in the case of breast tumor classification. In order to improve the differentiation of breast lesions, the authors proposed a method based on the segmentation of homodyned K distribution parameter maps. Regions within lesions of different scattering properties were extracted and analyzed. In order to improve the classification, the best-performing features were selected from various regions and then combined. METHODS A radio-frequency data set consisting of 103 breast lesions was used in the authors' analysis. Maps of homodyned K distribution parameters were created using an algorithm based on signal-to-noise ratio, kurtosis, and skewness of fractional-order envelope moments. A Markov random field model was used to segment parametric maps. Features of different segments were extracted and evaluated based on bootstrapping and the receiver operating characteristic curve. To determine the best-performing feature subset, the authors applied the joint mutual information criterion. RESULTS It was found that there were individual features which performed better than the ones commonly used for lesion characterization, like the parameter obtained through averaging of values over the whole lesion. The authors selected and discussed the best-performing features. Properties of different extracted regions were important and improved the distinction between benign and malignant tumors. The best performance was obtained by combining four features with the area under the receiver operating curve of 0.84. CONCLUSIONS The study showed that the analysis of internal changes in lesion parametric maps leads to a better classification of breast tumors. The authors recommend combining multiple features for characterization, instead of using only one parameter, especially in the case of heterogeneous lesions.
Blumea balsamifera—A Phytochemical and Pharmacological Review

The main components of sambong (Blumea balsamifera) are listed in this article. The whole plant and its crude extracts, as well as its isolated constituents, display numerous biological activities, such as antitumor, hepatoprotective, superoxide radical scavenging, antioxidant, antimicrobial and anti-inflammation, anti-plasmodial, anti-tyrosinase, platelet aggregation, enhancing percutaneous penetration, wound healing, anti-obesity, along with disease and insect resistant activities. Although many experimental and biological studies have been carried out, some traditional uses such as rheumatism healing still need to be verified by scientific pharmacological studies, and further studies including phytochemical standardization and bioactivity authentication would be beneficial.
Intracellular Accumulation of β-Amyloid in Cells Expressing the Swedish Mutant Amyloid Precursor Protein (*)

β-Amyloid (βA) is a normal metabolic product of the amyloid precursor protein (APP) that accumulates in senile plaques in Alzheimer's disease. Cells that express the Swedish mutant APP (Sw-APP) associated with early onset Alzheimer's disease overproduce βA. In this report, we show that expression of Sw-APP gives rise to cell-associated βA, which is not detected in cells that express wild-type APP. Cell-associated βA is rapidly generated, is trypsin-resistant, and is not derived from βA uptake, indicating that it is generated from intracellular processing of Sw-APP. Intracellular and secreted βA are produced with different kinetics. The generation of intracellular βA is partially resistant to monensin and a 20°C temperature block but is completely inhibited by brefeldin A, suggesting that it occurs in the Golgi complex. Monensin, brefeldin A, and a 20°C temperature block almost completely inhibit βA secretion without causing increased cellular retention of βA, suggesting that secreted βA is generated in a post-Golgi compartment. These results suggest that the metabolism of Sw-APP gives rise to intracellular and secreted forms of βA through distinct processing pathways. Pathological conditions may therefore alter both the level and sites of accumulation of βA. It remains to be determined whether the intracellular form of βA plays a role in the formation of amyloid plaques.
Hypertension Induced by Episodic Reductions in Uteroplacental Blood Flow in Gravid Rat

Background. The etiology of preeclampsia remains unclear. Animal modeling of preeclampsia has been useful; however, no model to date represents episodic changes in uteroplacental blood flow that may occur in preeclampsia. Objective. To develop a gravid rat model characterized by episodic reductions in uteroplacental blood flow. Method. Pregnant Sprague Dawley rats were used and subjected to SHAM, reduced uterine perfusion pressure (RUPP), or aortic occlusion on gestational Day 14. Aortic occlusion surgery consisted of implantation of a silastic vascular occluder around the abdominal aorta and silver clips around the uterine–ovarian arteries. Aortic occlusion animals were subjected to five consecutive days of occlusion (40% reduction) each session lasting 1 h. On Day 21, maternal mean arterial pressure (MAP) and fetal morphology were assessed. For isolated blood vessels, resistance-sized mesenteric arteries were harvested and mounted on a pressure arteriograph. Result. Occluder animals experienced a 10 mmHg rise in MAP as compared to SHAM (p < 0.05), and RUPP MAP was significantly increased as compared to control subjects (p < 0.05). Pups from Occluder animals exhibited a decrease in fetal weight as compared to SHAM (p < 0.05), but an increase in fetal weight as compared to RUPP (p < 0.05). Myogenic reactivity of second-order mesenteric arteries increased in Occluder animals as compared to SHAM (p < 0.05), but were similar to that of RUPP. Conclusion. Episodic reductions in uteroplacental blood flow play a crucial role in the altered vascular reactivity seen in Occluder animals and may represent a new model to investigate the mechanisms associated with episodic reductions in uteroplacental blood flow in pathological pregnancies.
Pediatric reference values for serum magnesium levels in Iranian subjects

Abstract Magnesium (Mg), an essential element, plays important roles in many physiological functions. Mg deficiency is associated with insulin resistance, cardiovascular disease, and disorders of the nervous system. The aim of this study was to determine reference values for serum Mg concentration in pediatrics. Serum Mg level was measured by flame atomic absorption spectrophotometry in 306 subjects (141 boys and 165 girls), aged 3–19 years, selected from among participants of the Tehran Lipid and Glucose Study. The International Federation of Clinical Chemistry guidelines (IFCC) and the robust method were used for determining reference values for sample sizes greater or less than 120 subjects respectively. The 95% reference values for serum Mg concentrations were 0.76–1.0, 0.75–1.0, and 0.76–0.99 mmol/L in boys, girls, and the all subjects respectively. According to the reference values obtained in this study, the prevalences of hypo- and hypermagnesemia, were 5.9% and 5.6% respectively. In conclusion, the current study presents pediatric reference values for serum Mg levels derived from a randomly selected healthy population, values which could be instrumental in detecting serum Mg abnormalities.
Prediction of Institutionalisation in Dementia

Background/Aims: In the past decades, a substantial number of studies considered factors influencing institutionalisation of persons with dementia. This study reviews recent work on predictors of actual institutionalisation in dementia. Method: Relevant articles were identified by a systematic search of the literature. Studies were considered which included persons aged 65 and over, and whose results were based on prospective design and on multivariate statistical analyses. Results: Forty-two studies were identified. The rate of institutionalisation increased from 20% in the first year after diagnosis to 50% after 5 years. Median time to institutionalisation was estimated between 30 and 40 months. Predictors of institutionalisation were classified according to a provided conceptual framework in the categories sociodemographic and relationship characteristics of persons with dementia and caregivers, primary stressors, secondary stressors and resources. Conclusion: The overview of research activities in this area showed a lack of methodological strength in a large part of identified studies. Nevertheless, a lot of well-examined and less highlighted predictors could be identified.
Rapid Detection of West Nile Virus in Birds Using the VecTest™ WNV Antigen Assay

OBJECTIVE: To determine if the VecTest™ West Nile Virus Antigen Assay (for testing mosquitoes) could be adapted to detect West Nile virus (WNV) rapidly and accurately in birds for screening purposes. DESIGN: Cloacal swabs and tissue (kidney and spleen) were harvested from 40 fresh dead birds. The VecTest was used for each swab specimen for detection of WNV; PCR was used for each tissue specimen for confirmation of WNV. SETTING: Mississippi Veterinary Diagnostic Laboratory (MVDL) in Jackson Mississippi and College of Veterinary Medicine-Mississippi State University (CVM-MSU) in Starkville Mississippi. SPECIMENS/SUBJECTS: Forty birds of the Corvid family (31 blue jays and 9 American crows) were included in the study. Fresh dead birds that died from no obvious cause were submitted for testing. RESULTS: VecTest results were 35 positives and 5 negatives. PCR results were 35 positives and 5 negatives. CONCLUSION: The VecTest showed 100% accuracy. ABBREVIATIONS: CVM-MSU = College of Veterinary Medicine-Mississippi State University; MVDL = Mississippi Veterinary Diagnostic Laboratory; PCR = polymerase chain reaction; PFU = plaque forming unit; RT-PCR = reverse transcription-nested polymerase chain reaction; SLE = St Louis encephalitis; VI = virus isolation; WNV = West Nile virus.
Investigation of Epizootic Shell Disease in American Lobsters (Homarus americanus) from Long Island Sound: II. Immune Parameters in Lobsters and Relationships to the Disease

ABSTRACT Epizootic shell disease (ESD) affects lobsters (Homarus americanus) in eastern Long Island Sound (ELIS) and the near-shore waters of southern New England. Marring the shell of individuals, ESD decreases the economic value of infected lobsters and can lead to mortality in severely affected individuals. ESD tends to be most common in areas around Buzzards Bay, RI, and ELIS, and least prevalent in offshore canyons, off Maine's coast, and in western Long Island Sound (WLIS). To investigate the potential role of the immune system in determining an individual's or population's susceptibility to ESD, the immunocompetence and disease status of lobsters with and without signs of ESD from ELIS, WLIS, and Boothbay Harbor, ME, were assessed during late spring (June) 2007. We also measured internal defense parameters of ELIS lobsters during midsummer (August 2007), early fall (October 2007), and the following spring (June 2008) to assess how lobster immune systems respond temporarily. Despite high interindividual variability in defense-related factors, multivariate analyses showed that lobsters from ELIS presented significantly reduced immune responses relative to lobsters from either WLIS or Maine. Disease severity correlated negatively with several immune parameters, suggesting that the higher prevalence of ESD in ELIS may be related, at least in part, to reduced immunocompetency of ELIS lobsters.
Meta-analysis on the effectiveness of alcohol screening with brief interventions for patients in emergency care settings.

BACKGROUND AND AIMS Despite ambiguous evidence for the effectiveness of alcohol screening with brief interventions (BI) in emergency departments (ED), ambition for their widespread implementation continues to grow. To clarify whether such an application of BI is justifiable, we conducted a systematic review and meta-analysis on studies testing the impact of BI on alcohol consumption. METHODS We included peer-reviewed, randomized controlled studies investigating the effects of BI on alcohol consumption in injured and/or intoxicated patients, published January 2002-September 2015. Changes from baseline in consumption quantity, intensity and number of heavy drinking episodes were assessed at 3-, 6- and 12-month follow-up, resulting in nine separate random-effects meta-analyses of standardized mean differences (SMD). Moderation effects of intervention mode, length, type of interventionist, intensity of control intervention and study quality were assessed using subgroup comparisons and meta-regression. RESULTS We considered 33 publications (28 separate studies) including 14 456 patients. Six of nine comparisons revealed small significant effects in favour of BI, with the highest SMD at 0.19 [95% confidence interval (CI) = 0.08-0.31]. No significant moderators could be identified, and statistical heterogeneity (I(2) ) was below 40%. CONCLUSIONS In a large meta-analysis of randomized controlled trials in emergency care settings, there was evidence for very small effects of brief interventions on alcohol consumption reductions. More intensive interventions showed no benefit over shorter approaches. Non-face-to-face interventions appear to be comparably effective, but this finding remains tentative due to the low number of non-face-to-face studies.
Minimal Clinically Important Differences in COPD Lung Function

The FEV1 is widely used by physicians in the diagnosis, staging, treatment, monitoring and establishing prognosis for patients with COPD. The MCID is the smallest difference which patients perceive as beneficial and which would mandate a change in patient management. A precise MCID for FEV1 has not been established. In attempt to establish a MCID for predose or trough FEV1, several limitations need to be addressed. There are issues such as reproducibility, repeatability, acceptability, variability, placebo effect, and equipment effects. Patient factors, such as baseline level of FEV1, albuterol reversibility, diurnal variation, influence the results. Nonetheless, using anchoring techniques, a change in pre dose FEV1 of about 100 mL can be perceived by patients, correlates with fewer relapses following exacerbations and is in the range usually achieved with bronchodilators approved for COPD. In the future, consistent reporting of spirometric variables, such as a predose FEV1 and other outcomes, can be incorporated into a more quantitative effort to establish the MCID. Also distributional/statistical methods may be useful in determining the MCID FEV1.