Miracle-dz/UniFAR-FTUs huggingface dataset:
Continuing medical education and primary care physicians in Saudi Arabia: perception of needs and problems faced

Objectives: To study the primary health care physician's perception of the need for continuing medical education, current continuing medical education activities and problems faced. Methods: A cross-sectional survey using a confidential, self-administered, and pre-tested questionnaire was conducted. The questionnaire was mailed to 441 primary care physicians practicing in health centers in 4 regions in Saudi Arabia. Methods of continuing medical education currently practiced, reasons preventing continuing medical education activities, content of continuing medical education as perceived by the physicians and factors affecting the easiness of keeping up-to-date were included. Results: The overall response rate was 66%. The majority of physicians practiced private reading (88%). attended lectures and presentations (59%) and discussion meetings in health centers (56%). as methods of continuing medical education. The main reasons for not attending continuing medical education activities were lack of time (59%), and pressure of work (52%). The majority of physicians would like to acquire more knowledge on clinical subjects (pediatrics 81%, emergency medicine 76%, Obstetrics/Gynecology 61% and dermatology 65%). For the future, the preferred methods for continuing medical education were clinical experience in hospitals (76%), lectures and presentations (70%) and private reading (63%). Physicians from urban health centers, from busy health centers and those who have more continuing medical education activities in health centers had more difficulty in keeping up-to-date. Conclusion: The two important problems preventing physicians working in health centers from attending continuing medical education activities were lack of time and pressure of work. These need to be tackled by planners of continuing medical education programs. Busy physicians and physicians in urban health centers need more help to keep up-to-date.
Flow Prediction in Spatio-Temporal Networks Based on Multitask Deep Learning

Predicting flows (e.g., the traffic of vehicles, crowds, and bikes), consisting of the in-out traffic at a node and transitions between different nodes, in a spatio-temporal network plays an important role in transportation systems. However, this is a very challenging problem, affected by multiple complex factors, such as the spatial correlation between different locations, temporal correlation among different time intervals, and external factors (like events and weather). In addition, the flow at a node (called node flow) and transitions between nodes (edge flow) mutually influence each other. To address these issues, we propose a multitask deep-learning framework that simultaneously predicts the node flow and edge flow throughout a spatio-temporal network. Based on fully convolutional networks, our approach designs two sophisticated models for predicting node flow and edge flow, respectively. These two models are connected by coupling their latent representations of middle layers, and trained together. The external factor is also integrated into the framework through a gating fusion mechanism. In the edge flow prediction model, we employ an embedding component to deal with the sparse transitions between nodes. We evaluate our method based on the taxicab data in Beijing and New York City. Experimental results show the advantages of our method beyond 11 baselines, such as ConvLSTM, CNN, and Markov Random Field.
Factors Associated with Internal Audit Effectiveness: Evidence from Greece

The current study investigates the specific factors associated with internal audit effectiveness in the Greek business environment. Empirical evidence was collected by means of a mailed survey. Factor Analysis and regression analysis are used in order to illustrate the gathered information. The findings indicate that the main factors affecting internal audit effectiveness are: (1) quality of internal audit, (2) competence of internal audit team, (3) independence of internal audit and (4) management support. The results also reveal that independence of internal audit is the foundation of internal audit effectiveness, as it is the most crucial factor in our model. Finally, the paper concludes that internal audit is of major importance for Greek business. Key words: Internal audit, Auditing, effectiveness of internal audit, Accounting, Greece.
FACTORS AFFECTING TREATMENT SEEKING BEHAVIOUR OF INDIVIDUALS WITH LOCOMOTOR DISABILITIES

Background: Among the different types of disabilities, the prevalence of locomotor disability is highest in the country. Quality of life and disability limitation is affected by the availability and utility of rehabilitative services. Thus knowledge of the treatment seeking behaviour will help in implementing successful intervention programmes. Materials and Methods: A community based cross-sectional observation study was conducted in an urban slum of Mumbai. Total sample of 3665 individuals were screened. 205 were identified with loco motor disabilities who were subjected to a structured questionnaire. The study was conducted over a period of 3 months. The data was analysed using SPSS software (Version 17). 95 % confidence limits for prevalence was calculated to estimate the prevalence in the general population and Chi-square test was applied to identify the association between two variables. Results: The prevalence of loco motor disabilities is found to be 5.59 %. Females were more affected than the males.75% of the sample was unemployed and 49.3 % was illiterate. Utility of rehabilitative services was found to be poor (35.6%). 50.7 % of these were treated by General practitioners. Very few approached speciality rehabilitative services. Low literacy levels and poor awareness of rehabilitation facilities were the major factors affecting treatment seeking pattern of individuals with locomotor disability (p<0.001) Conclusion: Improving literacy rates, developing community based rehabilitation services and training medical under-graduates, creating awareness regarding the available facilities, will lead to greater utilization of rehabilitative services and thus early diagnosis and disability limitation.
Cholesteatoma: a molecular and cellular puzzle.

HYPOTHESIS There are at least three possible molecular models of cholesteatoma pathogenesis. Cholesteatoma may arise as a result of 1) the induction of a preneoplastic or neoplastic transformation event; 2) a defective wound-healing process; and/or 3) a pathologic collision of the host inflammatory response, normal middle ear epithelium, and a bacterial infection. BACKGROUND There have been a number of speculations concerning the factors that foster the development of cholesteatoma. Before resolving the molecular basis for the pathogenesis of cholesteatomas, it is important to present and test plausible models that could explain how a cholesteatoma becomes invasive, migratory, hyperproliferative, aggressive, and recidivistic. METHODS The authors evaluated by various techniques (e.g., immunohistochemistry, flow cytometry, and image analysis) a large number of cholesteatomas of all types (e.g., primary and secondary acquired, recurrent, and congenital) and a range of normal tissues (tympanic membrane, canal wall skin, and postauricular skin) for the expression of various proteins (e.g., p53, ectopeptidases, tryptase) and for the presence of DNA aneuploidy. RESULTS AND CONCLUSIONS The authors' published and unpublished studies to date support several suppositions concerning the pathology of cholesteatomas. First, cholesteatoma epithelium behaves more like a wound-healing process than a neoplasm. The available evidence to date does not indicate that cholesteatomas have inherent genetic instability, a critical feature of all malignant lesions. Second, the induction of hyperproliferative cells in all layers of the cholesteatoma epidermis implicates a potential idiopathic response to both internal events as well as external stimuli in the form of cytokines released by infiltrating inflammatory cells. Third, the presence of bacteria may provide a critical link between the cholesteatoma and the host, which prevents the cholesteatoma epithelium from terminating specific differentiation programs and returning to a quiescent state in which it becomes minimally proliferative, nonmigratory, and noninvasive. Fourth, none of our data suggest that there are any obvious molecular or cellular differences among the various types of cholesteatomas (e.g., primary and secondary acquired, recidivistic, and congenital). Continued research should delineate the precise molecular and cellular dysfunction involved in the pathogenesis of cholesteatomas and how this knowledge can be useful in the clinical management of cholesteatomas.
As informações sensoriais para o controle postural

O equilibrio na postura ereta ocorre por meio da atuacao do controle postural, que obtem informacoes sensoriais do sistema visual, vestibular e somatossensorial.E tema de discussao se existe apredominância ou combinacao de informacao sensorial para o controle postural e se o conjunto de informacoes sensoriais e organizado de forma hierarquica ou nao. Assim, com as informacoes sensoriais sao organizadas para o controle postural? Qual e o papel de cada informacao sensorial no controle da postura ereta? Para buscar respostas para estes questionamentos, o objetivo deste artigo e discutir o papel das informacoes sensoriais no controle da postura ereta.
The presenting feature and role of general practitioners and non-neurosurgeon physicians in recognizing pediatric brain tumors.

AIM: To determine the presenting features and role of non-neurosurgeon physician in recognizing the signs and symptoms of brain tumours in children. METHOD: Medical records of 31 pediatric brain tumor patients treated in Department of Neurosurgery, Soetomo General Hospital, Airlangga University Faculty of Medicine, Surabaya from August 2005 to September 2006 were reviewed. RESULTS: Thirty five percents f parents went to pediatrician as their first contact physician, 25% to general practitioner, 20% neurologist, 20% to neurosurgeon. Neurosurgeon was the second and third contact physician receiving refferal from non-neurosurgeon physician. The most common symptoms were headache (71%), vomiting (61%), motor weakness (48%), visual disturbance (45%), decrease level of consciousness (45%) and seizures (38%), unsteadiness (35%). The most common symptoms that led the parents to find medical help at any time were motor disturbance (48%), vomiting (48%), visual disturbance (45%), unsteadiness (35%), decrease level of consciousness (32%), seizures (32%), headache (32%). All patients had neurological signs at diagnosis; 58% had papilloedema, 48% cranial nerve abnormalities, 35% cerebellar signs, 32% motor disturbance, 29% a reduced level of consciousness, 12% cranial enlargement. Duration of symptoms at admission was 1 months (32%), 2 months (42%), 3-6 months (19%), more than 6 months (7%). A short symptom interval was significantly associated with high grade tumours and patient age 3 years or younger. CONCLUSION: The symptoms and signs are often nonspecific, mimicking more common diseases. Therefore, the possibility of a brain neoplasm should always be considered, it materializes very rarely. Benign neurologic symptoms such as headache, which last for 2 months or more, should indicate the need of additional studies. Our results higlighted the neurologic impairments which might facilitate early recognition of a brain neoplasm. Neurologic problems as the only symptom of brain tumor may mislead pediatricians and neuropediatricians, so that a low index of suspicion may delay the diagnosis.
Work disability in psoriatic arthritis

Psoriatic arthritis is an inflammatory arthritis affecting a fifth of patients with skin psoriasis. Inflammation of the joints and tendons causes pain, stiffness, reduced function and disability. Work disability is increasingly recognised as an important, patient centred, functional measure of disease yet little is known about work disability in psoriatic arthritis. The overall aim of my thesis is to examine patient reported work disability in psoriatic arthritis by undertaking the following; • A systematic review of the relevant literature • Classification of a cohort of patients to study • Validation of a commonly used work outcome measure used in other rheumatic diseases • Selection of a suitable measure of structural damage to inflamed joints for investigating the associations of work disability in longitudinal observational studies. The results of the systematic review identified limited data reporting high levels of work disability associated with a wide variety of disease and non-disease related factors. The review also identified the lack of a validated outcome measure for use in psoriatic arthritis. I report the classification of a large single centre longitudinal cohort of patients with psoriatic arthritis and evidence supporting the retrospective application of a psoriatic arthritis classification criterion. Subsequently I report a preliminary validation study of the work productivity and activity impairment questionnaire to measure work disability in psoriatic arthritis and a further study comparing the existing measures of structural damage in psoriatic arthritis. Finally I developed and supervised a multicentre observational study to examine the associations of work disability in psoriatic arthritis. The study identified reduced work effectiveness to be associated with measures of disease activity, whereas unemployment was associated with recent disease onset, greater age and worse physical function. The study will provide a valuable cohort for prospective study of work disability and the effect of medical treatment and will form part of my planned post-doctoral studies.
A Text-Based Analysis of Corporate Innovation

We develop a new measure of innovation using the text of analyst reports of S&P 500 firms. Our text-based measure gives a useful description of innovation by firms with and without patenting and R&D (research and development). For nonpatenting firms, the measure identifies innovative firms that adopt novel technologies and innovative business practices (e.g., Walmart’s cross-geography logistics). For patenting firms, the text-based measure strongly correlates with valuable patents, which likely capture true innovation. The text-based measure robustly forecasts greater firm performance and growth opportunities for up to four years, and these value implications hold just as strongly for innovative nonpatenting firms. This paper was accepted by Gustavo Manso, finance.
2:16α-Hydroxyestrone Metabolite Ratio and Breast Cancer: A Combined Analysis

Estrogen metabolites may play an important role in breast carcinogenesis. Animal and in vitro studies suggest differing biological effects of the 2-hydroxyestrone (2-OHE1) and 16α-hydroxyestrone (16α-OHE1) metabolites, lending support to the use of 2:16α-OHE1 as a measure of estrogen balance. Although previous studies have evaluated the association between these specific metabolites and breast cancer among pre- and postmenopausal women, the results have been inconclusive. The sample size of individual studies is often small and lacks the statistical power to draw conclusions or to adequately assess the relationships within subgroups. Furthermore, the relationship between various lifestyle factors and personal characteristics and estrogen metabolites remains unclear. We evaluated the association between the 2-OHE1, 16α-OHE1 and 2:16α-OHE1 metabolites and breast cancer among premenopausal (183 cases/548 controls) and postmenopausal (319 cases/647 controls) women using a combined analysis of individual level data from previously published research studies. In separate study adjusted conditional logistic regression models matched on 5-year age groups, higher levels of 2:16α-OHE1 were not associated with breast cancer among pre- or postmenopausal women [Premenopausal: OR≥2.67 vs. <1.76=0.81 (95% CI: 0.49, 1.32); Postmenopausal: OR≥2.46 vs. <1.53=0.87 (95% CI: 0.58, 1.29)]. Using multivariable regression analyses adjusted for study, we evaluated various predictors of estrogen metabolites among the control populations of the participating studies (544 premenopausal/720 postmenopausal). Among premenopausal women, BMI was negatively associated with 2-OHE1 and 2:16α-OHE1 (p < 0.05). Analyses among postmenopausal women revealed significant associations (p<0.05) between age, age at menopausal status, and history of benign breast disease. In summary, this combined analysis does not support an association between urinary estrogen metabolites and breast cancer among pre- or post menopausal women. However, our results do suggest potential differences in factors related to estrogen metabolite levels among pre- and postmenopausal women. Enhancing our knowledge of estrogen metabolites among breast cancer patients and among healthy populations of women is a significant contribution to public health. By improving our understanding of estrogen metabolites we may be able to identify women at higher risk of breast cancer as well as increase our understanding of breast cancer etiology.
Jamaican Youth Risk and Resiliency Behaviour Survey 2005. School-based survey on risk and resiliency behaviours of 10-15 year olds.

The Jamaica Youth Risk and Resiliency Behaviour Survey a collaborative effort of the University of the West Indies (UWI) Mona the Jamaican Ministry of Health (MoH) and United States Agency for International Development/Jamaica Caribbean (USAID/J-CAR) with technical assistance from the MEASURE Evaluation Project gathered information from 1318 participants (599 males and 721 females) island-wide who were 15 - 19 years of age. The main objectives of the survey were to: describe lifestyle and behaviour patterns (exercise cigarette smoking and alcohol consumption) by demographic and socio-economic characteristics; determine and document the context of adolescent reproductive and sexual health including the magnitude determinants and consequences for adolescents lives; determine the association between resiliency and markers of abnormal mental health on risk-taking behaviours including involvement in violence; obtain anthropometric measurements fasting glucose levels and cholesterol levels in youth and relate these to chronic disease risks; and identify the sources of information influencing adolescents health and health seeking behaviour. The study provides important data on the health status health seeking behaviour risk and resiliency factors affecting Jamaican youth. Protective factors such as improved educational levels parental involvement and expectations and positive mental health trends should be augmented in order to improve reproductive and sexual health outcomes reduce risky behaviors and inform subsequent adolescent health policy and programmes. (excerpt)
Transient Ischemic Attack: A Dangerous Harbinger and an Opportunity to Intervene

Transient ischemic attack (TIA) and ischemic stroke are both characterized by sudden onset of neurological symptoms due to focal cerebral ischemia, but they are distinguished by the duration of neurological symptoms, with TIA traditionally defined by resolution of symptoms within 24 hours and stroke reserved for symptoms of longer duration. Because TIA and ischemic stroke share etiologies, it is not surprising that the recommended evaluations and secondary prophylaxis are identical. However, recent studies suggest that optimal management of TIA and stroke may differ more than previously recognized. The short-term risk of ischemic stroke after TIA is very high, which may be because rapid recovery from neurological symptoms is indicative of reversal of ischemia and tissue still at risk. Regardless of whether residual symptoms or infarction are present, rapid recovery appears to predict a greater short-term risk of subsequent ischemic stroke and is more likely to reflect a distinct, unstable pathophysiology. Therefore, it may be more useful to characterize acute ischemic cerebrovascular syndromes on the basis of the extent of rapid recovery (i.e., on the inferred reversal of ischemia) than on the completeness of recovery at 24 hours. Patients with substantial rapid recovery may be those for whom acute intervention is most warranted.
IMPACT OF ACCOUNTING STANDARDS ON THE VALUE RELEVANCE OF ACCOUNTING INFORMATION FROM NIGERIA’S LISTED FIRMS: COMPARATIVE STUDY OF PRE AND POST IFRS ADOPTION*

In compliance with Government’s directive, all listed companies in Nigeria adopted and applied IFRS in preparation of their financial reports from 2012. Following the adoption of IFRS, there is general expectation from shareholders and other stakeholders that the quality of financial reports from Nigerian companies will increase and in turn, the value of accounting information enhanced. This study investigates the impact of IFRS adoption on the value relevance of accounting information of Nigerian listed companies. For this purpose, the study uses sample of 67non- financial companies operating in different sectors of the Nigerian economy and listed on Nigerian Stock Exchange (NSE). This study, which covers period between 2007 and 2014, applies both return and price models to determine and compare the value relevance of accounting information in the pre and post IFRS adoption period. The findings under both models indicate that accounting information is more value relevant in post IFRS period but not significantly different from the pre IFRS period at least for the nonfinancial firms.
A School-Based HIV/AIDS Prevention Education Program: Outcomes of Peer-Led Versus Community Health Nurse-Led Interventions.

This study evaluated a brief school-based HIV/AIDS prevention intervention for adolescents delivered by either community health nurses (CHNs) or by trained peer educators (PEs). The interventions consisted of two one-hour sessions. Following the sessions subjects in the CHN-led (n = 58) and PE-led (n = 53) groups and a control group (n = 49) filled out questionnaires measuring HIV/AIDS prevention knowledge attitudes self-efficacy and behavioural intentions. Students in both the CHN and PE-led groups had significantly higher scores than controls in HIV/AIDS prevention knowledge and students in the PE-led group had significantly higher knowledge scores than students in the CHN-led group. Students in the PE-led group had significantly higher scores on the HIV/AIDS prevention attitudes self- efficacy and behavioural intentions questionnaire than did controls. There were no significant differences between the CHN-led group and the PE-led group in total attitude self-efficacy and behavioural intention scores. On specific questionnaire items concerning key predictor variables associated with condom use student scores indicated that the PE-led intervention and to a lesser extent the CHN-led intervention had a significant positive impact. The findings suggest that brief school-based interventions can improve adolescents short-term HIV/AIDS prevention knowledge attitudes self-efficacy and behavioural intentions. (authors)