Miracle-dz/UniFAR-FTUs huggingface dataset:
Radiographic Anatomy of the Infracochlear Approach to the Petrous Apex for Computer-Assisted Surgery

Objective: 1) To define the surgical anatomy and dimensions of the infracochlear approach to the petrous apex through the use of high-resolution computed tomography and 2) use of digitized images of cadaveric temporal bones for computer simulation of infracochlear access using the Ohio Supercomputer Center/Ohio State University temporal bone simulator. Background: The petrous apex is a surgically challenging area to access. Many routes have been described and used successfully in clinical practice. However, these routes have not been defined with the aim of application in computer-assisted surgery. The infracochlear approach, due to its access via a transcanal route, affords the opportunity for its potential application in minimally invasive computer-assisted surgery. Methods: High-resolution computed tomographic scans were performed on 102 cadaveric skulls (204 temporal bones). Standard measurements were taken using an open-source picture archiving and communication system software of the maximum height, width, and depth of the infracochlear approach. In addition, the maximum diameter of a circular fenestration that could be created in the infracochlear space without breaching the basal turn of the cochlea, internal carotid artery, or the jugular bulb was used to simulate a drill path. In addition, 5 temporal bone specimens (3 left, 2 right) underwent high-resolution computed tomography, with the digitized images being used to create simulated temporal bones for infracochlear surgical access; the transcanal infracochlear approach was then performed by the same surgeon on the cadaveric bone. Results: The mean height, width, and depth of the infracochlear space in temporal bones with nonpneumatized petrous apices were 7.2 ± 0.4, 9.4 ± 0.8, and 17.5 ± 1.0 mm, respectively. Corresponding dimensions in pneumatized petrous apices were 7.6 ± 0.4, 10.1 ± 1.1, and 18.6 ± 0.8 mm, respectively. The mean diameter of the circular fenestra in the nonpneumatized petrous apices was 5.1 ± 0.4 compared with 5.7 ± 0.6 mm in pneumatized petrous pieces. This was statistically significant (unpaired t test; p value = 0.04). The time to perform a simulated infracochlear approach to the petrous apex ranged from 3.1 to 12.6 minutes (mean, 6.1 minutes). The time to perform the same approach on the cadaveric bone ranged from 4.32 to 14.1 minutes (mean, 9.3 minutes). Conclusion: Temporal bones with pneumatized petrous apices have an overall larger infracochlear space. The mean diameter of a circular infracochlear path that would avoid damage to vital structures was sufficiently large in both pneumatized and nonpneumatized petrous apices to have a potential application as a safe approach in computer-assisted surgery. Such an application is feasible with mating of a robotic system with computed tomographic- or magnetic resonance imaging-guided imagery, which is the next phase of this study.
Informative Dorfman Screening

Summary Since the early 1940s, group testing (pooled testing) has been used to reduce costs in a variety of applications, including infectious disease screening, drug discovery, and genetics. In such applications, the goal is often to classify individuals as positive or negative using initial group testing results and the subsequent process of decoding of positive pools. Many decoding algorithms have been proposed, but most fail to acknowledge, and to further exploit, the heterogeneous nature of the individuals being screened. In this article, we use individuals’ risk probabilities to formulate new informative decoding algorithms that implement Dorfman retesting in a heterogeneous population. We introduce the concept of “thresholding” to classify individuals as “high” or “low risk,” so that separate, risk‐specific algorithms may be used, while simultaneously identifying pool sizes that minimize the expected number of tests. When compared to competing algorithms which treat the population as homogeneous, we show that significant gains in testing efficiency can be realized with virtually no loss in screening accuracy. An important additional benefit is that our new procedures are easy to implement. We apply our methods to chlamydia and gonorrhea data collected recently in Nebraska as part of the Infertility Prevention Project.
Intraoperative Neural Response Telemetry as a Predictor of Performance

Objective: To determine whether intraoperative neural response telemetry (tNRT) is predictive of postoperative speech perception. Study Design: Retrospective review. Setting: Tertiary referral center. Patients: Children (n = 24) aged between 5 and 17 years and adults 18 years and older (n = 73) with severe-to-profound hearing loss and implanted with the Nucleus Freedom device between 2005 and 2008 and observed at least 1 year were included. Intervention: Intraoperative neural response telemetry after insertion of the electrode array. Main Outcome Measure: Measures included 1) intraoperative tNRT measurements and 2) preoperative and 1-year postoperative open-set word recognition scores using age-appropriate open-set tests for children and adults. Intraoperative neural response telemetry levels for electrodes E20, E15, E10, and E5 in each patient were correlated to performance at the 1-year evaluation interval. Results: No correlation existed between tNRT responses and open-set speech performance at the 1-year evaluation. Several patients had absent tNRT in the OR but developed speech recognition abilities, whereas the remaining patients had intraoperative responses with levels of postoperative performance ranging from 0% to 100%. Conclusion: This study suggests that there is no significant correlation between intraoperative tNRT and speech perception performance at 1 year. At the time of surgery, tNRT provides valuable information regarding the electrical output of the implant and the response of the auditory system to electrical stimulation and preliminary device programming data; however, it is not a valuable predictor of postoperative performance. Furthermore, the absence of tNRT does not necessarily indicate a lack of stimulation.
Increased levels of alpha‐1‐acid glycoprotein and interleukin‐6 in refractory depression

Plasma concentrations of alpha-1-acid glycoprotein (AGP), C-reactive protein (CRP), interleukin-6 (IL-6), and soluble interleukin-6 receptor (sIL-6R) as well as the changes in glycosylation of AGP were measured in 60 patients with major depression hospitalized at the Department of Psychiatry, Medical Academy in Bydgoszcz, and in 20 age- and sex-matched controls. Thirty-four depressed patients met the criteria of refractory depression. Patients with refractory depression (RD) had a longer duration of the illness and the last depressive episode than the responders to antidepressant treatment. RD patients had higher concentrations of AGP, CRP, IL-6, and higher monocyte count as well as the different glycosylation patterns of AGP (higher values of reactivity coefficient, AGP-RC) compared with non RD patients. Depressed patients who exhibited DST non-suppression had significantly higher values of AGP than patients showing suppression on this test. These results may suggest an elevation of acute phase response in refractory depression. Depression 3:170–175 (1995). © 1995 Wiley-Liss, Inc.
Influenza Vaccination among Emergency Medical Services and Emergency Department Personnel

Objectives. Influenza vaccination has long been recommended for health care workers, but vaccination rates among this group have been low. Data on emergency medical services (EMS) personnel's vaccination status have not been published. This study compared self-reported vaccination rates and barriers among EMS and emergency department (ED) personnel. Methods. We conducted a cross-sectional survey of full-time EMS providers servicing metropolitan Rochester, New York, and a convenience sample of ED personnel in an academic medical center in Rochester, New York. Surveys, completed during July and August 2006, focused on influenza vaccination status for the 2005–2006 season and opinions regarding the vaccination. Immunization rates of EMS providers and ED personnel were compared using the chi-square calculation. Results. Surveys were completed by 128 EMS providers (100% of eligible) and 128 ED personnel (100% of approached). Among EMS providers, 27 of 128 (21%; 95% confidence interval [CI] 14%–29%), and among ED personnel, 83 of 128 (65%; 95% CI 56%–73%) reported receiving an influenza vaccination in the preceding year (p < 0.001). Among interventions that could lead to an increase in influenza vaccination, the most commonly chosen by EMS providers and ED personnel alike were “no waiting” vaccination at work (71% and 62%, respectively) and free vaccination (59% and 50%, respectively). When asked about important factors in the decision whether to get an influenza vaccination the following season, the most common responses were frequency of exposure (71%, 69%) and concern about secondarily exposing family members (62%, 60%). Conclusion. EMS providers reported low influenza vaccination levels in 2005–2006, even as compared with ED personnel. This failure to receive vaccination poses potential risk to the workers themselves and their patients. Resolution of reported barriers could lead to higher vaccination rates.
Developing Program Performance Measures for Rural Emergency Medical Services

ABSTRACT Background: The development of measures to monitor and evaluate the performance and quality of emergency medical services (EMS) systems has been a focus of attention for many years. The Medicare Rural Hospital Flexibility Program (Flex Program), established by Congress in 1997, provides grants to states to implement initiatives to strengthen rural healthcare delivery systems, including better integration of EMS into those systems of care. Objective: Building on national efforts to develop EMS performance measures, we sought to identify measures relevant to the rural communities and hospitals supported by the Flex Program. The measures are intended for use in monitoring rural EMS performance at the community level as well as for use by State Flex Programs and the Federal Office of Rural Health Policy (FORHP) to demonstrate the impact of the Flex Program. Methods: To evaluate the performance of EMS in rural communities, we conducted a literature search, reviewed research on performance measures conducted by key EMS organizations, and recruited a panel of EMS experts to identify and rate rurally-relevant EMS performance measures as well as emergent protocols for episodes of trauma, ST Elevation Myocardial Infarction (STEMI), and stroke. The rated measures were assessed for inclusion in the final measure set. Results: The Expert Panel identified 17 program performance measures to support EMS services in rural communities. These measures monitor the capacity of local agencies to collect and report quality and financial data, use the data to improve agency performance, and train rural EMS employees in emergent protocols for all age groups. Conclusion: The system of care approach on which this rural EMS measures set is based can support the FORHP's goal of better focusing State Flex Program activity to improve program impact on the performance of rural EMS services in the areas of financial viability, quality improvement, and local/regional health system performance.
Use of high‐normal levels of haemoglobin A1C and fasting plasma glucose for diabetes screening and for prediction: a meta‐analysis

Using high‐normal levels of haemoglobin A1C (Abnormal‐A1C) or fasting plasma glucose (FPG) (Abnormal‐FPG) for diabetes screening are expected to improve the ability to detect persons with or at high risk of diabetes. We assessed the diagnostic and predictive capacity for diabetes of Abnormal‐A1C and Abnormal‐FPG. We compared these to the combined use of the two measures to the single use of either measurement.
FAMILY PRESERVATION SERVICES: TYPES OF SERVICES RENDERED BY SOCIAL WORKERS TO AT-RISK FAMILIES

Family preservation services are considered essential in order to avoid the removal of children from their families. In accordance with South African legislation and policy documents, social workers at family welfare organisations must focus on family preservation services in order to prevent children being placed in foster care. Theoretically family preservation services consist of different types of services, namely family support services, family-centred services and intensive family preservation services, or crisis services. In this article the different types of services will be discussed with reference to policy documents. The services delivered by social workers in the context of family preservation are reviewed.
Effectiveness of IEC Programme on the Nursing Students with Regard to Management of Children with ARI (Pneumonia) and Diarrhea Based on IMNCI Guidelines

A quantitative (experimental) research approach with "One group pre-test post-test design" (preexperimental) was used to assess and evaluate the effectiveness of IEC programme in terms of knowledge and practice of B.Sc. (Nursing) students with regard to management of children with Acute Respiratory Infection (ARI) and Diarrhea based on IMNCI guidelines in a selected nursing college of Delhi with the objectives: 1. To develop IEC programme. 2. To assess the knowledge and practice before and after administration of IEC programme.3. To seek relationship between knowledge and practice after the administration of IEC programme. Sample consisted of thirty one (31) 3rd year B.Sc student nurses of Rufaida College of Nursing, New Delhi. The study was conducted at Rufaida College of Nursing and Health Centre and Maternity Home, IPP-VIII, Badarpur, New Delhi. Total enumeration sampling technique was used to select the subjects and data was collected using a predesigned, tested, valid and reliable structured knowledge questionnaire and structured observation checklist. The findings of study revealed that the mean post-test knowledge score (33.29) was significantly higher than the mean pre-test knowledge score (22.03) and the computed ‘Z’ value (15.21) for knowledge was greater than the standard ‘Z’ value of (1.96). The mean post-test practice score (33.58) was significantly higher than the mean pre-test practice score (22.26) and the computed ‘Z’ value (10.88) for practice was greater than the standard ‘Z’ value of (1.96). The calculated value of coefficient of correlation (r) 0.399 is greater than the table value (0.355) at df (29) which indicates that there is significant positive relationship between post-test knowledge and post-test practice scores. The study concluded that IEC based on IMNCI guidelines was useful in enhancing the knowledge and practice of student nurses.Study recommended that research needs to be done on other aspects of IMNCI
Transcranial Attenuation of Bone-Conducted Sound When Stimulation Is at the Mastoid and at the Bone Conduction Hearing Aid Position

Hypothesis The transcranial attenuation of bone-conducted (BC) sound depends on the stimulation position and the stimulation frequency. Background Subjective transcranial attenuation of BC sound has previously only been measured at a few audiometric frequencies and with the stimulation at the mastoid. The results reported are on average of 5 to 10 dB with large intersubject variability and inconsistent with results obtained using vibration measurements of the cochlea. Methods Pure tone hearing thresholds were measured in 28 unilateral deaf subjects at 31 frequencies between 0.25 and 8 kHz. The stimulation was provided at 4 positions: ipsilateral and contralateral mastoid, and ipsilateral and contralateral position for a bone conduction hearing aid. Results With stimulation at the mastoid, the median transcranial attenuation is 3 to 5 dB at frequencies up to 0.5 kHz; between 0.5 and 1.8 kHz, it is close to 0 dB. The attenuation increases at higher frequencies; it is close to 10 dB at 3 to 5 kHz and becomes slightly less at the highest frequencies measured (4 dB at 8 kHz). When measured at the bone conduction hearing aid position, the median transcranial attenuation is 2 to 3 dB lower than at the mastoid. The intersubject variability is large at each frequency (around 40 dB), but there are small differences in general trends of the transcranial attenuation between individuals. Conclusion The median transcranial attenuation depends on stimulation position and frequency. However, the variability is great, both between individuals and within subjects for adjacent frequencies.
Screening assays to find out late latent syphilis cases – which is the best one?

The serological methods for diagnosis of syphilis are classified into non-specific (non-treponemal) such as Rapid Plasma Reagin (RPR), and specific (treponemal) such as Treponema pallidum hemagglutination test (TPHA) and Enzyme-linked immunosorbent assay IgG, IgM (ELISA IgG, IgM) tests. The aim of this retrospective study was to estimate and compare the sensitivity and specificity of RPR, TPHA and Syphilis ELISA IgG, IgM. The study was conducted on 18 799 clinically healthy persons who had visited the Outpatient clinic of Ministry of the Interior Clinical Centre, Latvia during 2 years period from August 2006 to November 2007. Patients were screened to find out possible late latent syphilis cases by using RPR, TPHA and ELISA IgG, IgM assays. The results showed the highest sensitivity indices of ELISA IgG, IgM and TPHA methods, and the lowest for the RPR test. Highest specificity indices were observed by using ELISA IgG, IgM method followed by TPHA method with lower values and RPR method showing the lowest specificity. To conclude, ELISA IgG, IgM and TPHA methods should be used for screening late latent syphilis cases and ELISA IgG, IgM for diagnosis confirmation. RPR is not recommended for screening purposes.
Awareness and the use of Insecticide Treated Net (ITN) among pregnant women attending ante-natal at Usmanu Danfodiyo University Teaching Hospital, Sokoto

Malaria remains a major public health problem, causing significant maternal and child morbidity and mortality annually in sub-Saharan Africa. The use of insecticide treated bed nets (ITN) is one of WHO recommended multipronged approach to combating malaria, but public awareness of the importance of this method vary from community to community. This study was therefore undertaken with the aim of assessing the current knowledge and use of ITN among pregnant women attending antenatal clinic at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methodology used was a descriptive crosssectional study of randomly selected 111 pregnant women attending the ANC. A set of structured interviewer administered questionnaire was also used to extract information from the respondents. The result indicates that 101 (91%) of the respondents had formal education and had heard of ITN, mainly through hospital sources (56.4%, x=57, n=101). However, only 59 (53.2%) of them own a net, supplied by government (21 or 35.6%) or purchased (32 or 54.2%) by the individual. 25 (42.4%) of the respondents used the net everyday but 31(52.5%, n=59) of them claimed to have used it the previous night. It was concluded from this study that although the knowledge of ITN was high (91%) amongANC attending women in study area, this did not (p>0.05) translate to ownership (53.2%) which in-turn did not (p>0.05) mean usage of net. There was a need to create more awareness of the anti-malarial significance of the ITN, through intensive health education in this and other such areas with endemic drug resistant malaria and insufficient health infrastructure, for the achievement of the objectives of theWHOGlobal Malaria Programme (GMP) and the United Nation Millenium Development Goal.
A Theoretical Framework for Consumer E-Satisfaction and Site Stickiness: An Evaluation in the Context of Online Hotel Reservations

E-satisfaction, defined in this study as overall satisfaction with an e-vendor's website, is considered an important factor in encouraging loyalty to that site. Yet, to date, findings have varied tremendously, in both the strength of the satisfaction-loyalty relationship and factors surrounding it. We approach the study of e-satisfaction and e-loyalty (here termed “site stickiness”) from a site-specific perspective, meaning that we focus on consumer perceptions of satisfaction with, and loyalty toward, the information technology (IT) artifact (website) itself, excluding outside influences, such as offline interactions with the e-vendor and postconsumption experiences. We further seek to understand the satisfaction-stickiness relationship in the context of the hospitality industry, where loyalty programs are believed to play a key role in impacting consumer behavior. We ground our research model in Bagozzi's 1992 framework of the self-regulation of attitudes, intentions, and behavior, and test it using a survey of 4838 consumers who visited a large hotel chain's website for the specific purpose of researching room rates and availability as a prelude to booking a room. Results generally support the proposed model. Post hoc analyses indicate that while trust is not a significant direct predictor of satisfaction, it negatively moderates the value-satisfaction relationship. Loyalty card membership, while an important predictor of site stickiness, does not moderate the satisfaction-stickiness relationship as suggested in prior research. This indicates further research is necessary to explore other ways of conceptualizing the impact of loyalty programs, such as investigating member vestedness.
Third-Generation Bisphosphonates for Treatment of Sensorineural Hearing Loss in Otosclerosis

Objective To evaluate hearing outcomes in patients treated with third generation bisphosphonates for otosclerosis-related sensorineural hearing loss (SNHL). Hypothesis Otosclerosis is a disease of abnormal bone remodeling in the otic capsule. In recent years, third generation bisphosphonates, with more powerful anti-resorptive properties and increased bone affinity, have demonstrated effectiveness in the treatment of osteoporosis and other metabolic bone diseases. We hypothesized that newer generation bisphosphonates, such as risedronate and zoledronate, would be effective in slowing the progression of SNHL in patients with otosclerosis. Study Design Retrospective review. Setting Tertiary referral center, ambulatory care. Interventions Risedronate or zoledronate administration. Main Outcome Measures Bone conduction pure tone threshold averages (PTAs) and word recognition (WR) scores were examined for each ear before and after bisphosphonate treatment. Criteria for significant change were defined as greater than 10 decibels in PTA or between 4% and 18% in WR based on binomial variance. Results All 10 patients had audiometric progression of SNHL in the pretreatment monitoring interval and 12 ears met criteria for significant progression. All 10 patients (19 ears) showed at least no significant progression of SNHL (i.e., stabilization) at an average follow-up of 13 months. Two patients (3 ears) showed improvement by defined audiometric criteria. There were no major complications. Conclusion Treatment with zoledronate or risedronate stabilized progressive SNHL related to otosclerosis in this small group of patients. Further evaluation of third-generation bisphosphonate treatments is warranted.