Miracle-dz/UniFAR-FTUs huggingface dataset:
Research Paper: Evaluation of User Acceptance of a Clinical Expert system

OBJECTIVE To measure the attitudes of physicians and nurses who use the Health Evaluation through Logical Processing (HELP) clinical information system. DESIGN Questionnaire survey of 360 attending physicians and 960 staff nurses practicing at the LDS Hospital. The physicians' responses were signed, permitting follow-up for nonresponse and use of demographic data from staff files. The nurses' responses were anonymous and their demographic data were obtained from the questionnaires. MEASUREMENTS Fixed-choice questions with a Likert-type scale, supplemented by free-text comments. Question categories included: computer experience; general attitudes about impact of the system on practice; ranking of available functions; and desired future capabilities. RESULTS The response rate was 68% for the physicians and 39% for the nurses. Age, specialty, and general computer experience did not correlate with attitudes. Access to patient data and clinical alerts were rated highly. Respondents did not feel that expert computer systems would lead to external monitoring, or that these systems might compromise patient privacy. The physicians and nurses did not feel that computerized decision support decreased their decision-making power. CONCLUSION The responses to the questionnaire and "free-text comments" provided encouragement for future development and deployment of medical expert systems at LDS Hospital and sister hospitals. Although there has been some fear on the part of medical expert system developers that physicians would not adapt to or appreciate recommendations given by these systems, the results presented here are promising and may be of help to other system developers and evaluators.
Evaluation of diagnostic reliability of micronuclei in potentially malignant disorders of oral cavity

Context: Micronucleus (MN) has been proved to be an important biomarker of genomic damage. MN scoring in oral exfoliated epithelial cells has been used in the past as a biomarker to identify different preneoplastic conditions much earlier than the manifestations of clinical features. However, no attention has been, until now, given to determine the overall accuracy of MN assay in diagnosing potentially malignant disorders (PMDs). Aim: The present study was being conducted to evaluate the diagnostic accuracy of MN assay in PMDs of oral cavity. Materials and Methods: Cytosmears from 30 controls with healthy mucosa and 45 cases as patients with suspicious lesions, clinically diagnosed as PMDs of the oral cavity were taken and separately stained with Papanicolaou (Pap) stain and haematoxylin and eosin (H and E) stain. MN frequency was evaluated and based on the 50 th percentile of all the MN (%) frequency values obtained for both the groups combined; a cut off value was calculated independently for each stain. Results: The sensitivity and specificity with Pap stain was found to be 84% and 93%, respectively, with diagnostic accuracy of 88%, whereas with H and E stain, sensitivity of 89% and specificity of 100% with diagnostic accuracy of 93% was observed. Conclusion: MN assay in oral exfoliated epithelial cells can be conveniently used as a biomarker for the screening of PMDs of oral cavity.
Impacts of battery charging rates of Plug-in Electric Vehicle on smart grid distribution systems

Plug-in Electric Vehicles (PEVs) will be an integral part of smart grids in the near future. This paper studies the impacts of different PEV battery charging profiles on the performance of smart grid distribution systems. PEVs are already growing in popularity as a low emission mode of transport versus conventional petroleum based vehicles. Utilities are becoming concerned about the potential stresses and overloads that may occur with multiple domestic PEV charging activity. Smart grids will play an important role in PEV operation because the battery chargers can be coordinated by the utility and harnessed for storing surplus grid energy and reused to support the grid during peak times. Therefore, an analysis is performed for a smart grid distribution system to demonstrate the impacts of different PEV charging scenarios. The paper compares charging rates (e.g., slow, medium and fast charging), PEV penetration levels as well as different charging periods over a 24 hour period considering existing system load profiles, and evaluates the overall performance of the distribution system. The impact on system load profile, total losses, transformer loading and voltage profile is examined.
Evaluation of Haematinic Activity and Subchronic Toxicity of Sphenocentrum jollyanum (Menispermaceae) Seed Oil

Aim: The haematinic activity and subchronic toxicity of Sphenocentrum jollyanum (Menispermaceae) seed oil was evaluated and compared with the control. Materials and Methods: In acute toxicity study the animals tolerated up to 16 g/kg body weight (bw) of the extract in 2 % Tween 80 solution administered orally after 24 hrs fast. Another set of mice (6 per group) fasted for 24 hrs were administered with the extract intra-peritoneal (IP) at different doses (250, 500, 1000, 2000 mg/kg bw) until 100% mortality was achieved. In subchronic toxicity study, 300, 600 and 1200 mg/kg bw of the extract in 2 % Tween 80 were administered on the animals for 120 days. Results: In acute toxicity study, the extract was found to be non toxic when it was administered orally for up to 16 g/kg bw within 24 hrs. Subchronic toxicity test showed no mortality after 120 days of oral administration. The animals showed appreciable increase in feeding habit and water intake. Increase in body and vital organs weights occurred while tissue histology showed no abnormal features. The liver function profile showed no significant difference (p ≥ 0.05) compared to the control except for the albumin that increased markedly. The extract led to significant increase (p < 0.05) in RBC. The packed cell volume (PCV) and haemoglobin count (Hb) increased with increase in dose. On the other hand, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and white blood cells (WBC), did not vary markedly. Similarly, WBC differentials did not record appreciable difference compared to the control. Conclusion: The result showed that SJ seed oil possessed haematinic and hepatoResearch Article
Electronic Information Systems and Social Work: Who are We Designing For?

Historically, the reluctance of social workers to use digital technology has been noted, though this is changing as its use has become increasingly ubiquitous in both personal and professional life. The introduction of software to create case records and record service activity, generically known as electronic information systems (IS), has been particularly problematic, attracting criticism that it has undermined frontline social work practice. Initiatives to develop IS in order that they promote and support good practice are underway, and key dimensions of the design process are the aptitudes of the social workers and service users who will be engaging with IS. In this article, observations from an ethnographic programme of research that aims to redesign IS for the future and literature about technology usage are more generally drawn upon. Taking a lead from user-centred approaches to the design of technology, the characteristics, expectations and attitudes of both social workers and service users of the current and near future are explored in relation to their use of digital technology. Particular attention is paid to the consequences of this analysis for participatory approaches to IS design, which aim to include the perspectives of social workers and service users.
Ad hoc classification of radiology reports.

OBJECTIVE The task of ad hoc classification is to automatically place a large number of text documents into nonstandard categories that are determined by a user. The authors examine the use of statistical information retrieval techniques for ad hoc classification of dictated mammography reports. DESIGN The authors' approach is the automated generation of a classification algorithm based on positive and negative evidence that is extracted from relevance-judged documents. Test documents are sorted into three conceptual bins: membership in a user-defined class, exclusion from the user-defined class, and uncertain. Documentation of absent findings through the use of negation and conjunction, a hallmark of interpretive test results, is managed by expansion and tokenization of these phrases. MEASUREMENTS Classifier performance is evaluated using a single measure, the F measure, which provides a weighted combination of recall and precision of document sorting into true positive and true negative bins. RESULTS Single terms are the most effective text feature in the classification profile, with some improvement provided by the addition of pairs of unordered terms to the profile. Excessive iterations of automated classifier enhancement degrade performance because of overtraining. Performance is best when the proportions of relevant and irrelevant documents in the training collection are close to equal. Special handling of negation phrases improves performance when the number of terms in the classification profile is limited. CONCLUSIONS The ad hoc classifier system is a promising approach for the classification of large collections of medical documents. NegExpander can distinguish positive evidence from negative evidence when the negative evidence plays an important role in the classification.
Review of high‐dose intravenous vitamin C as an anticancer agent

In the 1970s, Pauling and Cameron reported increased survival of patients with advanced cancer treated with high‐dose intravenous (IV) vitamin C (L‐ascorbate, ascorbic acid). These studies were criticized for their retrospective nature and lack of standardization of key prognostic factors including performance status. Subsequently, several well‐designed randomized controlled trials failed to demonstrate a significant survival benefit, although these trials used high‐dose oral vitamin C. Marked differences are now recognized in the pharmacokinetics of vitamin C with oral and IV administration, opening the issue of therapeutic efficacy to question. In vitro evidence suggests that vitamin C functions at low concentrations as an antioxidant but may have pro‐oxidant activity at high concentrations. The mechanism of its pro‐oxidant action is not fully understood, and both intra‐ and extracellular mechanisms that generate hydrogen peroxide have been proposed. It remains to be proven whether vitamin C‐induced reactive oxygen species occur in vivo and, if so, whether this will translate to a clinical benefit. Current clinical evidence for a therapeutic effect of high‐dose IV vitamin C is ambiguous, being based on case series. The interpretation and validation of these studies is hindered by limited correlation of plasma vitamin C concentrations with response. The methodology exists to determine if there is a role for high‐dose IV vitamin C in the treatment of cancer, but the limited understanding of its pharmacodynamic properties makes this challenging. Currently, the use of high‐dose IV vitamin C cannot be recommended outside of a clinical trial.
Review: Considerations for the Design of a Web-based Clinical Monitoring and Educational System for Elderly Patients

Designing a Web system for elderly patients requires attention to the users' functional impairments and inexperience with computers. The authors reviewed published guides for the design of Web-based clinical systems for elderly patients and identified additional design considerations that have not been reported in the literature. The resulting recommendations are related to the system interface, the training and support of users, and the content of Web pages. The recommendations can be used as design objectives for Web-based systems for elderly patients, which emphasize system usability and aim to optimize patients' error-free use of these systems.
Health Risks of Selected Performance-Enhancing Drugs

This article reviews adverse effects of and the difficulty of attributing toxic effects to selected drugs and dietary supplements that purportedly enhance athletic performance. On surveys estimating the extent of performance-enhancing drug use, 5% of high school students indicated anabolic-adrenergic steroid use, and approximately 28% of collegiate athletes and 5.6% of middle and high school athletes admitted creatine use. Many adverse health effects from the abuse of androgenic-anabolic steroids and androstenedione (a prodrug) are exaggerations of excessive testosterone on hepatic, cardiovascular, reproductive, and behavioral functions that can produce permanent changes. With creatine use, nausea, vomiting, diarrhea, elevated serum transaminase concentrations, hypertension, fluid retention, muscle cramping, and muscle strains have been reported. Ephedra stimulates adrenergic receptors, leading to tachycardia and hypertension, with central nervous system effects of anxiety, tremor, and hyperactivity. From 1997 to 1999, 10 people died and 13 suffered permanent disabilities due to ephedra. γ-Hydroxybutyrate and several prodrugs (γ-butyrolactone and 1,4-butanediol) can produce alternating agitation and coma, amnesia, hypotonia, ataxia, nystagmus, tremors, bradycardia, respiratory depression, and apnea. Although γ-hydroxybutyrate abuse began as a bodybuilding aid, most serious adverse effects are from acute overdoses. Adverse effects from performance-enhancing drugs do occur, but their extent and frequency are unknown.
Pseudohypoaldosteronism in a Female Infant and Her Family: Diversity of Clinical Expression and Mode of Inheritance

ABSTRACT. Pseudohypoaldosteronism was diagnosed in an infant that clinically presented severe failure to thrive and vomiting. Evaluation of her extended family revealed many other affected family members with a vast range of clinical expression. The mode of inheritance is most likely autosomal dominant. Salt supplementation during infancy was effective in restoring normal growth, weight gain and serum electrolytes.
The reaction of CH3O2 radicals with OH radicals: a neglected sink for CH3O2 in the remote atmosphere.

for CH3O2 in the Remote Atmosphere Christa Fittschen,*,† Lisa K. Whalley,‡,§ and Dwayne E. Heard‡,§ †Universite ́ Lille 1, PhysicoChimie des Processus de Combustion et de l’Atmospher̀e PC2A, Cite ́ Scientifique, Bat. C11, 59655 Villeneuve d’Ascq, France ‡School of Chemistry, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, U.K. National Centre for Atmospheric Science, University of Leeds, Leeds, LS2 9JT, U.K.
Learning in Context: Perceived Benefits of Fieldwork Education within Community Mental Health Settings

The emphasis on community-based services for people with psychiatric disorders requires a concerted response from occupational therapists, if we are to assist people to live meaningful lives in their own communities. This article draws on the fieldwork experiences of 16 Australian and American occupational therapy students, to reflect on fieldwork education and how it may be preparing students to meet the demands of proactive practice in psychiatry. Attention is drawn to the Importance of fieldwork education in community contexts for occupational therapy students, if these future therapists are to be adequately prepared for the demands of community mental health practice.
Effect of solar radiation on the optical properties and molecular composition of laboratory proxies of atmospheric brown carbon.

Sources, optical properties, and chemical composition of atmospheric brown carbon (BrC) aerosol are uncertain, making it challenging to estimate its contribution to radiative forcing. Furthermore, optical properties of BrC may change significantly during its atmospheric aging. We examined the effect of photolysis on the molecular composition, mass absorption coefficient, and fluorescence of secondary organic aerosol (SOA) prepared by high-NOx photooxidation of naphthalene (NAP SOA). Our experiments were designed to model photolysis processes of NAP SOA compounds dissolved in cloud or fog droplets. Aqueous solutions of NAP SOA were observed to photobleach (i.e., lose their ability to absorb visible radiation) with an effective half-life of ∼15 h (with sun in its zenith) for the loss of near-UV (300-400 nm) absorbance. The molecular composition of NAP SOA was significantly modified by photolysis, with the average SOA formula changing from C14.1H14. 5O5.1N0. 085 to C11.8H14. 9O4.5N0. 023 after 4 h of irradiation. However, the average O/C ratio did not change significantly, suggesting that it is not a good metric for assessing the extent of photolysis-driven aging in NAP SOA (and in BrC in general). In contrast to NAP SOA, the photobleaching of BrC material produced by the reaction of limonene + ozone SOA with ammonia vapor (aged LIM/O3 SOA) was much faster, but it did not result in a significant change in average molecular composition. The characteristic absorbance of the aged LIM/O3 SOA in the 450-600 nm range decayed with an effective half-life of <0.5 h. These results emphasize the highly variable and dynamic nature of different types of atmospheric BrC.
Laparoscopic cholecystectomy in a patient of Situs Inversus at Regional Institute of Medical Sciences (RIMS)

Situs inversus is also known as situs transversus or oppositus and is a congenital condition. In this condition, the major visceral organs are observed to be reversed or mirrored from their normal position. Symptomatic cholelithiasis in a patient of situs inversus can give rise to diagnostic dilemma and calls for modification of the surgeon's operative approach. Owing to the rarity of the condition, here, we report a case of laparoscopic cholecystectomy in a patient of situs inversus at Regional Institute of Medical Sciences (RIMS). Though operative time was slightly prolonged and there were minor orientation difficulties, intra-operative and post-operative periods were uneventful and there is no report of complication till date.
Myocardial infarction with normal coronaries: an autopsy perspective

Aim To analyse postmortem cases of myocardial infarction (MI) with normal coronary arteries in terms of patient characteristics, features of the MI and risk factors. Methods This retrospective non-case controlled study was carried out at a specialist cardiac pathology department at a tertiary cardiac referral centre. Cases of histologically confirmed MI and normal coronary arteries during the period 1996–2010 were identified and analysed for the presence of risk factors. Results Nineteen cases of histologically confirmed MI and normal coronary arteries were identified with a similar gender ratio 1:1.1 (male:female) and mean age of 33±12 years (range 14–58). All patients died suddenly. The location of the infarct was variable, with left anterior descending artery territory being the single most prevalent (47%). Risk factors were identified in the majority of cases (n=14), with some cases experiencing more than one association, including alcohol and/or predominately class A drug use (n=7), including cocaine, inflammation (n=2), hypercoagulable state (n=3) and exertion (n=2). Conclusions Current data regarding prognosis in MI with normal coronary arteries suggests a favourable outcome in the context of major cardiovascular events. No large series of fatal cases have been reported. This study highlights that this entity can be fatal and its prognosis may be less favourable than currently considered. This autopsy series also demonstrates that the causation of MI with normal coronary arteries is complex and multifactorial, including a history of alcohol and/or drug use. It also highlights the importance of accurate epidemiological data from referring pathologists.
Valsartan in the treatment of hypertension

Valsartan is a widely used, efficacious and very well-tolerated antihypertensive agent. By specifically blocking the action of angiotensin II on the angiotensin Type 1 receptor, valsartan reduces unwanted effects of angiotensin II, such as aldosterone, vasopressin and endothelin secretion, vasoconstriction, diuresis, endothelial cell hyperplasia, mitogenesis, induction of growth factors and production of collagen. Valsartan has a simple pharmacokinetic profile and requires no metabolism to become active. The dose-related efficacy of valsartan has been clearly demonstrated and the tolerability profile is similar to placebo. Clinical trials in elderly patients show good efficacy and high responder rates with the same doses as in younger patients. Valsartan is available as 80-, 160- and 320-mg tablets, and also in the same doses in combination with hydrochlorothiazide, 12.5 or 25 mg. Availability varies between countries. Beyond the reduction of blood pressure, valsartan is indicated for use in several count.
Enhanced biomedical scientist cut-up role in colonic cancer reporting

Aims To extend the biomedical scientist (BMS) cut-up role to include gastrointestinal category D colorectal cancer resection specimens, and to address issues of quality and safety by presenting performance data from the first 50 BMS cut-up specimens in comparison with national guidelines and pathologist performance over the same timeframe. Methods Close mentoring and consultant supervision was carried out for every case with adherence to standard operating procedures and following colorectal cancer dataset guidelines as published by the Royal College of Pathologists. Performance targets were audited including anticipated spread of Dukes' stage, targets for mean lymph node harvest, percentage extramural vascular invasion and serosal involvement, and mean tumour blocks sampled. Histological pre-reporting of 20 cases was encouraged, and time spent by BMS and consultant at all stages of specimen reporting was noted. Results Performance targets were all exceeded by the BMS and compared favourably with pathologist performance. A measure of consultant cut-up and histology reporting time saved was identified. Conclusions Benefits of extending the BMS role to category D specimens may include BMS professional advancement, efficient use of consultant time and the development of a team approach to cancer reporting. The achievement of colorectal cancer performance targets and favourable comparison with pathologist performance implies there was no perceived detrimental effect on quality or safety and thus patient management.
Intestinal Staphylococcus spp. and virulent features associated with coeliac disease

Aim To determine whether intestinal Staphylococcus spp. and their pathogenic features differed between coeliac disease (CD) patients and healthy controls. Methods 60 children, including active CD (n=20) and non-active CD (n=20) patients and healthy controls (n=20), were studied. Staphylococci were isolated from faeces and identified by PCR and DNA sequencing. The carriage of virulent genes, including adhesion (atlE and fbe), cell aggregation (icaD), global regulatory (agr and sar) and methicillin-resistant (mecA) genes, was analysed by PCR. Results Staphylococcus epidermidis was more abundant in the microbiota of active and non-active CD patients than in controls. Staphylococcus haemolyticus was more abundant in active CD patients than in control subjects. Staphylococcus aureus was less abundant in active CD patients than in the other child groups. Staphylococcus spp. diversity was higher in active CD patients than in non-active CD patients and controls. The presence of the mecA gene and the simultaneous presence of both the mecA and atlE genes were higher in S. epidermidis clones isolated from CD patients, with active and non-active disease, than in those from control subjects. The individual presence of the other virulent genes was lower in S. epidermidis from active CD patients than in those from the other -child- groups. Conclusions Increased abundance of S. epidermidis carrying the mecA gene, in active and non-active CD patients, most likely reflects increased exposure of these subjects to opportunistic pathogens and antimicrobials.