Miracle-dz/UniFAR-FTUs huggingface dataset:
The contentious nature of gestational diabetes: diet, insulin, glyburide and metformin

Gestational diabetes (GD) develops because pregnancy increases requirements for insulin secretion while increasing insulin resistance. Women with GD often have impaired pancreatic β-cell compensation for insulin resistance. The nature of GD is currently contentious, with debate about its existence, diagnosis and ramifications for both mother and offspring from pregnancy into later life. Also contentious are the outcomes of intervention with diet, insulin, glyburide (Glynase™, Pharmacia Upjohn) and metformin (Glucophage™, Bristol-Myers Squibb). There is consensus that women with unequivocal GD have a significant risk of adverse perinatal outcomes and increased risk of later type 2 diabetes mellitus. Foetuses from pregnancies with GD have a higher risk of macrosomia (associated with higher rate of birth injuries), asphyxia, and neonatal hypoglycaemia and hyperinsulinaemia. Uncontrolled GD predisposes foetuses to accelerated, excessive fat accumulation, insulin resistance, pancreatic exhaustion secondary to prenatal hyperglycaemia and possible higher risk of child and adult obesity and type 2 diabetes mellitus later in adult life. However, there is no consensus as to whether glucose intolerance of a severity below unequivocal GD is related to adverse maternal, fetal or perinatal outcomes, and whether this relationship is a continuous one. If dietary intervention is not sufficient in the treatment of GD, then, historically, insulin has been added. Recent studies suggest that glyburide may be efficaciously substituted for insulin. Preliminary studies suggest that metformin may have the unique potential to prevent the development of GD.
Microbiota Dysbiosis Controls the Neuroinflammatory Response after Stroke

Acute brain ischemia induces a local neuroinflammatory reaction and alters peripheral immune homeostasis at the same time. Recent evidence has suggested a key role of the gut microbiota in autoimmune diseases by modulating immune homeostasis. Therefore, we investigated the mechanistic link among acute brain ischemia, microbiota alterations, and the immune response after brain injury. Using two distinct models of acute middle cerebral artery occlusion, we show by next-generation sequencing that large stroke lesions cause gut microbiota dysbiosis, which in turn affects stroke outcome via immune-mediated mechanisms. Reduced species diversity and bacterial overgrowth of bacteroidetes were identified as hallmarks of poststroke dysbiosis, which was associated with intestinal barrier dysfunction and reduced intestinal motility as determined by in vivo intestinal bolus tracking. Recolonizing germ-free mice with dysbiotic poststroke microbiota exacerbates lesion volume and functional deficits after experimental stroke compared with the recolonization with a normal control microbiota. In addition, recolonization of mice with a dysbiotic microbiome induces a proinflammatory T-cell polarization in the intestinal immune compartment and in the ischemic brain. Using in vivo cell-tracking studies, we demonstrate the migration of intestinal lymphocytes to the ischemic brain. Therapeutic transplantation of fecal microbiota normalizes brain lesion-induced dysbiosis and improves stroke outcome. These results support a novel mechanism in which the gut microbiome is a target of stroke-induced systemic alterations and an effector with substantial impact on stroke outcome. SIGNIFICANCE STATEMENT We have identified a bidirectional communication along the brain–gut microbiota–immune axis and show that the gut microbiota is a central regulator of immune homeostasis. Acute brain lesions induced dysbiosis of the microbiome and, in turn, changes in the gut microbiota affected neuroinflammatory and functional outcome after brain injury. The microbiota impact on immunity and stroke outcome was transmissible by microbiota transplantation. Our findings support an emerging concept in which the gut microbiota is a key regulator in priming the neuroinflammatory response to brain injury. These findings highlight the key role of microbiota as a potential therapeutic target to protect brain function after injury.
Does culture matter? A qualitative and comparative study on eLearning in Germany and China

eLearning offers the exciting opportunity to acquire new material at any time and any place. It is also a means to teach a large number of people simultaneously, which is an important aspect when thinking about challenges in fast growing countries like China. We suggest that the successful usage of eLearning requires the consideration of didactic socialization. While prior research has primarily focused on the overall success factors of eLearning, there is little understanding about how a specific learning culture context influences its usefulness. This study intends by a use of a proxy approach to investigate culture-sensitive success factors of eLearning measures regarding overall satisfaction and learning success. The results of the comparison of the German and East Asian learning context show that there are culturally specific requirements of eLearning success that cater to the specific didactic socialization.
Empathy in Dentistry: How Attitudes and Interaction With Older Adults Make a Difference

The development of empathy and positive attitudes are essential elements of professional education. This study explored the nature of empathy and its association with attitudes about, and exposure to older patients in a sample of dental students. Students completed an adapted version of the Jefferson Scale of Physician Empathy (JSPE), the Aging Semantic Differential (ASD) and answered questions about their exposure to older people. Factor analysis was used to identify four factors: (1) Empathy is Valuable, (2) Empathy is Demonstrated, (3) Empathy is not Influential, and (4) Empathy is Difficult to Accomplish. Higher empathy scores were related to the ASD subscale attitude of acceptability of aging and to greater exposure to older adults outside of clinical practice. There were no demographic predictors of higher empathy scores.
Nonoperative Active Management of Critical Limb Ischemia: Initial Experience Using a Sequential Compression Biomechanical Device for Limb Salvage

Critical limb ischemia (CLI) patients are at high risk of primary amputation. Using a sequential compression biomechanical device (SCBD) represents a nonoperative option in threatened limbs. We aimed to determine the outcome of using SCBD in amputation-bound nonreconstructable CLI patients regarding limb salvage and 90-day mortality. Thirty-five patients with 39 critically ischemic limbs (rest pain = 12, tissue loss = 27) presented over 24 months. Thirty patients had nonreconstructable arterial outflow vessels, and five were inoperable owing to severe comorbidity scores. All were Rutherford classification 4 or 5 with multilevel disease. All underwent a 12-week treatment protocol and received the best medical treatment. The mean follow-up was 10 months (SD ± 6 months). There were four amputations, with an 18-month cumulative limb salvage rate of 88% (standard error [SE] ± 7.62%). Ninety-day mortality was zero. Mean toe pressures increased from 38.2 to 67 mm Hg (SD ± 33.7, 95% confidence interval [CI] 55–79). Popliteal artery flow velocity increased from 45 to 47.9 cm/s (95% CI 35.9–59.7). Cumulative survival at 12 months was 81.2% (SE ± 11.1) for SCBD, compared with 69.2% in the control group (SE ± 12.8%) (p = .4, hazards ratio = 0.58, 95% CI 0.15–2.32). The mean total cost of primary amputation per patient is €29,815 ($44,000) in comparison with €13,900 ($20,515) for SCBD patients. SCBD enhances limb salvage and reduces length of hospital stay, nonoperatively, in patients with nonreconstructable vessels.
Identification of new key genes for type 1 diabetes through construction and analysis of protein–protein interaction networks based on blood and pancreatic islet transcriptomes

Type 1 diabetes (T1D) is an autoimmune disease in which pancreatic β‐cells are destroyed by infiltrating immune cells. Bilateral cooperation of pancreatic β‐cells and immune cells has been proposed in the progression of T1D, but as yet no systems study has investigated this possibility. The aims of the study were to elucidate the underlying molecular mechanisms and identify key genes associated with T1D risk using a network biology approach.
How Do Batters Use Visual, Auditory, and Tactile Information About the Success of a Baseball Swing?

Bat/ball contact produces visual (the ball leaving the bat), auditory ( the “crack” of the bat), and tactile (bat vibration) feedback about the success of the swing. We used a batting simulation to investigate how college baseball players use visual, tactile, and auditory feedback. In Experiment 1, swing accuracy (i.e., the lateral separation between the point of contact and “sweet spot”) was compared for no feedback (N), visual alone, auditory alone, and tactile alone. Swings were more accurate for all single-modality combinations as compared to no feedback, and visual produced the greatest accuracy. In Experiment 2, the congruency between visual, tactile, and auditory was varied so that in some trials, the different modalities indicated that the simulated ball contacted the bat at different points. Results indicated that batters combined information but gave more weight to visual. Batting training manuals, which typically only discuss visual cues, should emphasize the importance of auditory and tactile feedback in baseball batting.
No evidence for preferential involvement of medial temporal lobe structures in high-functioning autism

Background. Autism is a neurodevelopmental disorder associated with slight increases in brain volume. There has been some suggestion that medial temporal lobe structures may be preferentially involved in this disorder, although results have not always been consistent. Here, we investigate amygdala and hippocampus volumes in medication-naive subjects with high-functioning autism. Method. Whole-brain magnetic resonance imaging scans were acquired from 42 patients and 42 closely matched, healthy control subjects. Results. Amygdala volume did not differ significantly between patients and controls. A significant increase in hippocampal volume was proportional to an increase in overall brain volume. Conclusions. These results argue against preferential involvement of medial temporal lobe structures in autism, at least in high-functioning medication-naive individuals.
Hammering Versus Drilling of Sharp and Obtuse Trocar-Point K-Wires

Kirschner wire characteristics affect the heating of bone during insertion and the subsequent strength of fixation. We inserted 90 sharp and 90 obtuse trocar-tip K-wires into 90 fresh frozen human cadaver metacarpals using either a drill or a pneumatic hammer. The temperature elevation, insertion time and extraction force were measured for four K-wire insertion combinations: drilling sharp; drilling obtuse; hammering sharp; hammering obtuse. Hammering resulted in significantly lower temperature elevations than drilling. Hammering sharp K-wires resulted in the highest extraction forces. The first and fifth metacarpals showed significantly lower temperature elevations than the other metacarpals, while the insertion time was significantly higher in the second and third metacarpal than in the other metacarpals. Hammering sharp trocar-tip K-wires minimises thermal damage to bone and gives the strongest fixation.
Clinician and patient perspectives of a new model of triage in a community rehabilitation program that reduced waiting time: a qualitative analysis.

BACKGROUND A trial of a new model of triage (Specific and Timely Appointments for Triage: STAT) at a community rehabilitation program (CRP) reduced the mean time to first appointment from 17.5 to 10.0 days. However, quantitative findings reveal little about the impact of the system on those who used it. We aimed to explore the experiences of patients and clinicians following the introduction of STAT. METHOD Qualitative study within a convergent mixed-methods design applied to a controlled before and after trial at a CRP. Semi-structured interviews (n=32) were conducted with clinicians who experienced the change to STAT, patients admitted to the CRP using STAT and patients who attended rehabilitation via a triaged wait list at another site. RESULTS Clinicians reported shorter waiting times, more flexibility and increased efficiency with STAT, and noted the importance of effective change management. Patients reported a more efficient and consistent pathway to rehabilitation with STAT. Waiting had negative consequences for some patients at the triaged wait list site. CONCLUSIONS The qualitative data provide context to the quantitative results by showing that the changes that reduced waiting times were also well accepted and perceived to be beneficial by both patients and clinicians. What is known about the topic? Triage systems are widely used but can contribute to inefficiencies in health care. An alternative method of triage (STAT) using early allocation to face-to-face appointments has been shown to reduce waiting times in a community rehabilitation service. What does this paper add? This paper explains and adds important context to the quantitative findings by exploring the perceptions of the staff and patients who experienced both the existing and alternative models of triage. What are the implications for practitioners? The STAT model was well received by staff and patients, suggesting that this simple intervention was a feasible and effective method of reducing waiting times for community rehabilitation, and may be applicable to other services that share similar features.
The STRIDE weight loss and lifestyle intervention for individuals taking antipsychotic medications: a randomized trial.

OBJECTIVES The STRIDE study assessed whether a lifestyle intervention, tailored for individuals with serious mental illnesses, reduced weight and diabetes risk. The authors hypothesized that the STRIDE intervention would be more effective than usual care in reducing weight and improving glucose metabolism. METHOD The study design was a multisite, parallel two-arm randomized controlled trial in community settings and an integrated health plan. Participants who met inclusion criteria were ≥18 years old, were taking antipsychotic agents for ≥30 days, and had a body mass index ≥27. Exclusions were significant cognitive impairment, pregnancy/breastfeeding, recent psychiatric hospitalization, bariatric surgery, cancer, heart attack, or stroke. The intervention emphasized moderate caloric reduction, the DASH (Dietary Approaches to Stop Hypertension) diet, and physical activity. Blinded staff collected data at baseline, 6 months, and 12 months. RESULTS Participants (men, N=56; women, N=144; mean age=47.2 years [SD=10.6]) were randomly assigned to usual care (N=96) or a 6-month weekly group intervention plus six monthly maintenance sessions (N=104). A total of 181 participants (90.5%) completed 6-month assessments, and 170 (85%) completed 12-month assessments, without differential attrition. Participants attended 14.5 of 24 sessions over 6 months. Intent-to-treat analyses revealed that intervention participants lost 4.4 kg more than control participants from baseline to 6 months (95% CI=-6.96 kg to -1.78 kg) and 2.6 kg more than control participants from baseline to 12 months (95% CI=-5.14 kg to -0.07 kg). At 12 months, fasting glucose levels in the control group had increased from 106.0 mg/dL to 109.5 mg/dL and decreased in the intervention group from 106.3 mg/dL to 100.4 mg/dL. No serious adverse events were study-related; medical hospitalizations were reduced in the intervention group (6.7%) compared with the control group (18.8%). CONCLUSIONS Individuals taking antipsychotic medications can lose weight and improve fasting glucose levels. Increasing reach of the intervention is an important future step.
Does an IRS Degrade Out-of-Band Performance?

Intelligent reflecting surfaces (IRSs) were introduced to enhance the performance of wireless systems. However, from a cellular service provider’s view, a concern with the use of an IRS is its effect on out-of-band (OOB) quality of service. Specifically, given two operators, say X and Y, providing services in a geographical area using non-overlapping frequency bands, if operator-X uses an IRS to optimally enhance the throughput of its users, does the IRS degrade the performance of operator-Y? We answer this by deriving the ergodic sum spectral efficiency (SE) of both operators under round-robin scheduling. We also derive the complementary cumulative distribution function of the change in effective channel at an OOB user with and without the IRS, which provides deeper insights into OOB performance. Surprisingly, we find that even though the IRS is randomly configured from operator-Y’s view, the OOB operator still benefits from the IRS, witnessing a performance enhancement for free. This happens because the IRS introduces additional paths between the nodes, increasing the signal power at the receiver and providing diversity benefits. We verify our findings numerically and conclude that an IRS is beneficial to every operator, even when the IRS is deployed to optimally serve only one operator.
An Improved Data Mining Model to Predict the Occurrence of Type-2 Diabetes using Neural Network

People in today's world get affected by many diseases that do not have a complete cure. The development of one disease may lead to various other complications. One such disease is Type-2 Diabetes. It is a global health problem. This is the most common type of diabetes usually developed at the age of 40 and older. This increases the risk factors like kidney failure, heart disease, blindness, nerve damage and blood vessel damage. It is predicted from the characteristics of the patients. A Hybrid Prediction Model (HPM) has been developed using k-means clustering and C4. 5 classifier. In that model, the dataset is initially cleaned and then Z-score normalization is applied on this dataset. A pattern is extracted from this using clustering. A model was built on this extracted pattern using the c4. 5 classifier. This produced an accuracy of 92. 38%. This classification accuracy can be improved by using Neural network. This improved model separates the dataset into either one of the two groups. This model has
Collective Theory for Surface Enhanced Raman Scattering.

We present an implementation of Maxwell's equations on adaptive meshes in order to study interaction of light with metal surfaces. For the first time it is possible to handle surfaces consisting of complex particles close enough to interact strongly. A fully retarded implementation allows treatment of large particles as well as small. By way of example we model a rough silver surface as an array of half-cylinders embedded in a silver surface. Very localized plasmon modes, created by strong electromagnetic coupling between touching metallic objects, dominate the surface enhanced Raman scattering response.
A P-Stable Linear Multistep Method For Solving General Third Order Ordinary Differential Equations

A P-stable linear multistep method for solving general third order initial value problems of ordinary differential equations without first reducing the problems into a system of first order equations is considered. The approach for the development of this method is essentially based on collocation of the differential system generated from a basis function. A predictor for the evaluation of $y_{n+k}$ for an odd $k\ge 3$ in the main method is also proposed. The two resulting methods, the corrector and the predictor are P-stable for $k = 3$ . These as a block are tested on a number of problems to show their efficiency. When the methods (the corrector and the predictor) are evaluated at $x = x_{n+3}$ identical schemes are obtained as special cases of the methods, while the set of first and second derivatives obtained from the corrector are different from those obtained from the predictor.
Resection of hepatocellular carcinoma with diaphragmatic invasion

Fourteen consecutive patients with hepatocellular carcinoma (HCC) and diaphragmatic invasion found during operation and confirmed histopathologically were studied. They were treated by resection of the liver tumour en bloc with part of the diaphragm. Eight of the 14 patients had a diaphragmatic hump on chest radiography. Pre‐operative ultrasonography, computed tomography and hepatic angiography were unable to diagnose diaphragmatic invasion in these patients. A control group of 14 closely matched patients were selected from 98 undergoing curative resection for HCC during the period of the study. No evidence of a diaphragmatic hump was found in the control patients (P < 0·001). There was no significant difference in survival, operative morbidity or mortality rates between the two groups. In patients with HCC situated in the dome of the liver, the presence of a diaphragmatic hump on chest radiography strongly suggests invasion of the diaphragm. There was no difference in outcome in patients with or without diaphragmatic invasion; the tumour should be resected if the patient is fit for operation.
Es rentable la decisión de estudiar en Colombia

En este articulo se estudia la dinamica de los retornos de la educacion en Colombia entre 1985 y 2000. La metodologia econometrica incluye una ecuacion de salarios con splines lineales y regresiones por percentiles (RP). Se muestra que los retornos varian a traves de diferentes niveles de escolaridad; asi, los retornos son altos con educacion universitaria; tambien, como se esperaba, con educacion postuniversitaria se tienen retornos altos en algunos anos de la muestra. La evidencia proporcionada por RP muestra un comportamiento ciclico del salario real; ademas, esta metodologia tambien muestra una distribucion condicional heterogenea del salario.
Electronic Social Media in Teaching : Usages , Benefits , and Barriers as Viewed by Sudanese Faculty Members

The purpose of this paper is to investigate the current use of social media and its benefits in teaching and learning as well as the perception of barriers by Sudanese university faculty members. The study surveyed a sample of 65 faculty members (educators and non-educators) through the use of a questionnaire. The results indicated that educators, both male and female, across academic ranks are using social media tools and agree to the benefits and barriers of social media usage. Also, the study found that there was a significant difference in the scores for educator and non-educator faculty members regarding social media usage in teaching, with the former demonstrating greater use. Moreover, the results found no significant effect of age and rank on faculty members’ use of social media in teaching. Therefore, the study recommends that future research on usage of social media sites in teaching could be extended to include a wider demographic base to further explore the extent to which the findings are generalizable. The study provided valuable information that may help administrators, professors, and decision makers to recognize the extent to which university faculty members’ use social media in teaching.