Miracle-dz/UniFAR-FTUs huggingface dataset:
Outcomes of implementation of the FilmArray meningoencephalitis panel in a tertiary hospital between 2017 and 2020

Background Acute meningoencephalitis is encountered commonly in the acute hospital setting and is associated with significant morbidity and mortality, in addition to significant healthcare costs. Multiplex PCR panels now allow syndromic testing for central nervous system infection. The BioFire® FilmArray® Meningoencephalitis (ME) allows testing of 14 target pathogens using only 0.2mls of cerebrospinal fluid (CSF). We conducted a retrospective observational study to assess the performance of the assay and secondarily to observe the clinical utility of negative results by comparing clinical outcomes of aseptic meningitis to bacterial and viral meningoencephalitis. Methods Data for CSF samples tested using the FilmArray ME panel from October 2017 to October 2020 were analysed. Detection of bacterial and viral targets was analysed. Admission to critical care area, 90-day readmission rates, average length of stay and 30-day and 90-day mortality were analysed for three groups with following diagnoses: bacterial meningitis, viral meningoencephalitis, or aseptic meningitis. Results From October 2017 to October 2020, 1926 CSF samples were received in the Clinical Microbiology laboratory. Of those, 543 CSF samples from 512 individual patients were tested using the FilmArray ME panel. Twenty-one bacterial targets and 56 viral targets were detected during the study period. For viral targets, the cumulative specificity was 98.9% (95% confidence interval: 93.1–99.9) when compared to the reference laboratory methods. The outcomes for 30- and 90-day mortality of the aseptic meningitis group were non-inferior relative to the viral meningoencephalitis and bacterial meningitis group. Patients with bacterial meningitis had a longer average length of stay. Aseptic meningitis was associated with a higher 90-day readmission rate than the other 2 groups, but without statistical significance. Conclusion In our hands, implementation of the FilmArray ME panel was relatively straightforward. We experienced a transition in our workflow processes that enabled streamlining of CSF diagnostics and the safe removal of Gram staining in those samples being tested by this molecular assay. Coupled to this improvement, there was a positive clinical impact on patient care due to rapid turnaround time to results.
Testing implementation facilitation for uptake of an evidence-based psychosocial intervention in VA homeless programs: A hybrid type III trial

Background Healthcare systems face difficulty implementing evidence-based practices, particularly multicomponent interventions. Additional challenges occur in settings serving vulnerable populations such as homeless Veterans, given the population’s acuity, multiple service needs, and organizational barriers. Implementation Facilitation (IF) is a strategy to support the uptake of evidence-based practices. This study’s aim was to simultaneously examine IF on the uptake of Maintaining Independence and Sobriety Through Systems Integration, Outreach and Networking-Veterans Edition (MISSION-Vet), an evidence-based multicomponent treatment engagement intervention for homeless Veterans with co-occurring mental health and substance abuse, and clinical outcomes among Veterans receiving MISSION-Vet. Methods This multi-site hybrid III modified stepped-wedge trial involved seven programs at two Veterans Affairs Medical Centers comparing Implementation as Usual (IU; training and educational materials) to IF (IU + internal and external facilitation). Results A total of 110 facilitation events averaging 27 minutes were conducted, of which 85% were virtual. Staff (case managers and peer specialists; n = 108) were trained in MISSION-Vet and completed organizational readiness assessments (n = 77). Although both sites reported being willing to innovate and a desire to improve outcomes, implementation climate significantly differed. Following IU, no staff at either site conducted MISSION-Vet. Following IF, there was a significant MISSION-Vet implementation difference between sites (53% vs. 14%, p = .002). Among the 93 Veterans that received any MISSION-Vet services, they received an average of six sessions. Significant positive associations were found between number of MISSION-Vet sessions and outpatient treatment engagement measured by the number of outpatient visits attended. Conclusions While staff were interested in improving patient outcomes, MISSION-Vet was not implemented with IU. IF supported MISSION-Vet uptake and increased outpatient service utilization, but MISSION-Vet still proved difficult to implement particularly in the larger healthcare system. Future studies might tailor implementation strategies to organizational readiness. Trial registration ClinicalTrials.gov, NCT02942979.
Maternity waiting homes utilization and associated factors among childbearing women in rural settings of Finfinnee special zone, central Ethiopia: A community based cross-sectional study

Background Maternity waiting home (MWH) is one of the strategies designed for improved access to comprehensive obstetric care for pregnant women living far from health facilities. Hence, it is vital to promote MWHs for pregnant women in Ethiopia, where most people reside in rural settings and have a high mortality rate. Therefore, this study aimed to assess MWHs utilization and associated factors among women who gave birth in the rural settings of Finfinnee special zone, central Ethiopia. Methods A community-based cross-sectional study was conducted from 15th October to 20th November 2019 among women who gave birth in the last six months before data collection. Multistage random sampling was employed among 636 women from six rural kebeles to collect data through a face-to-face interview. Multivariable logistic regression analysis was fitted, and a 95% confidence level with a p-value <0.05 was used to determine the level and significance of the association. Results Overall, MWHs utilization was 34.0% (30.3% - 37.7%). The higher age (AOR: 4.77; 95% CI: 2.76–8.24), career women (AOR: 0.39 95% CI: 0.20–0.74), non-farmer husband (AOR: 0.28; 95% CI: 0.14–0.55), rich women (AOR:1.84; 95% CI: 1.12–3.02), living greater than 60 minutes far from a health facility (AOR: 1.80; 95% CI: 1.16–2.80), and four and more livebirths (AOR: 5.72; 95% CI: 1.53–21.35) significantly associated with MWHs utilization. The common services provided were latrine, bedding, and health professional checkups with 98.2%, 96.8%, and 75.4%, respectively. Besides, feeding service was provided by 39.8%. The primary reason not to use MWHs was the absence of enough information on MWHs. Conclusion One-third of the women who delivered within the last six months utilized MWHs in the Finfinnee special zone. Our results support the primary purpose of MWHs, that women far from the health facility are more likely to utilize MWHs, but lack of adequate information is the reason not to use MWHs. Therefore, it is better to promote MWHs to fill the information gap among women with geographical barriers to reach health facilities.
Lightweight rowers’ perspectives of living with Relative Energy Deficiency in Sport (RED-S)

Objective To compete in lightweight rowing, strict limits are placed on the maximum body weight of each individual. As a result, lightweight rowers commonly restrict calorie intake despite high energy expenditure. This can result in Relative Energy Deficiency in Sport (RED-S). The aim of this study is to investigate the physical and psychosocial impact of RED-S, from the perspective of lightweight rowers. Design Semi-structured individual qualitative interviews. Participants Adults living in the United Kingdom who are current or former lightweight rowing participants and experienced ≥1 symptom of RED-S. Method Audio-recorded semi-structured individual telephone interviews were performed. Data was analysed using an inductive thematic approach, coding was iterative and data-driven, facilitated by NVivo software. Results Twelve current or former lightweight rowers (intermediate to international standard, 67% female, aged 19–32 years) participated. Participants restricted calories and increased energy expenditure to elicit weight-loss in order to meet weight requirements. This resulted in psychosocial implications (reduced social interaction, difficulty maintaining relationships, poor emotional regulation, low mood, poor concentration, disordered eating, guilt and anxiety around food, and a negative body image). Some psychosocial implications persisted after retirement from lightweight rowing. Participants described a range of physical implications, including disrupted sleep, decreased performance and recovery, bowel disruption, menstrual dysfunction, fatigue, musculoskeletal pain, injury and weakened immune systems. Conclusions This study describes short and long-term physical and psychosocial impacts of RED-S from the perspective of lightweight rowers. Findings highlight the importance of effective RED-S prevention and management strategies for lightweight rowers. These findings may be used to educate health-care professionals, coaches and athletes on the personal impacts and serious health consequences of RED-S.
Species-specific enamel differences in hardness and abrasion resistance between the permanent incisors of cattle (Bos primigenius taurus) and the ever-growing incisors of nutria (Myocastor coypus)

Hypselodont (ever-growing) teeth of lagomorphs or rodents have higher wear rates (of a magnitude of mm/week), with compensating growth rates, compared to the non-ever-growing teeth of ungulates (with a magnitude of mm/year). Whether this is due to a fundamental difference in enamel hardness has not been investigated so far. We prepared enamel samples (n = 120 per species) from incisors of cattle (Bos primigenius taurus) and nutria (Myocastor coypus, hypselodont incisors) taken at slaughterhouses, and submitted them to indentation hardness testing. Subsequently, samples were split into 4 groups per species (n = 24 per species and group) that were assessed for abrasion susceptibility by a standardized brush test with a control (no added abrasives) and three treatment groups (using fine silt at 4 ±1 μm particle size, volcanic ash at 96 ±9 μm, or fine sand at 166 ±15 μm as abrasives), in which enamel abrasion was quantified as height loss by before-and-after profilometry. The difference in enamel hardness between the species was highly significant, with nutria enamel achieving 78% of the hardness of cattle enamel. In the control and the fine sand group, no enamel height loss was evident, which was attributed to the in vitro system in the latter group, where the sand particles were brushed out of the test slurry by the brushes’ bristles. For fine silt and volcanic ash, nutria enamel significantly lost 3.65 and 3.52 times more height than cattle. These results suggest a relationship between enamel hardness and susceptibility to abrasion. However, neither the pattern within the species nor across the species indicated a monotonous relationship between hardness and height loss; rather, the difference was due to qualitative step related to species. Hence, additional factors not measured in this study must be responsible for the differences in the enamel’s susceptibility to abrasion. While the in vitro brush system cannot be used to rank abrasive test substances in terms of their abrasiveness, it can differentiate abrasion susceptibility in dental tissue of different animal species. The results caution against considering enamel wear as a similar process across mammals.
Center backs work hardest when playing in a back three: The influence of tactical formation on physical and technical match performance in professional soccer

The purpose of this study was to investigate whether tactical formation affects the physical and technical match performance of professional soccer players in the first German Bundesliga. From official match data of the Bundesliga season 2018/19, physical (total distance, high-intensity distance, sprinting distance, accelerations, maximum velocity) and technical performance (short/middle/long passes, dribblings, ball-possessions) of players were analyzed. Players were categorized into five playing positions (center back, full back, central midfielder, wide midfielder, forward) and teams into eight different tactical formations (4-4-2, 4-4-2 diamond, 4-2-2-2, 4-3-3, 4-5-1, 4-2-3-1, 3-4-3, 3-5-2). Results revealed that the degree to which tactical formation affects match performance is position dependent. In terms of physical performance, center backs and full backs showed highest sprinting distances when playing in a formation with only three defenders in the back row (3-4-3, 3-5-2) compared to all other formations (ES range: 0.13≤ES≤1.27). Regarding technical performance, all positions except forwards displayed fewer short passes, middle passes and ball-possessions in the formations 4-3-3 and 4-2-3-1 compared to all other formations (0.02≤ES≤1.19). In conclusion, physical and technical performance of center backs, full backs and wide midfielders differed markedly between the tactical formations. Conversely, the physical and technical performance of central midfielders and forwards only showed small differences between the different tactical formations. These findings can help coaches scheduling their practice. For example, if a coach wants to change the playing formation, he can anticipate the physical and technical match performance changes depending on the respective playing position.
Cold In-Place Recycling Moisture-Related Design and Construction Considerations for Single or Multiple Component Binder Systems

In recent years, cold in-place recycling (CIR) has gained momentum because of its economic, performance, and sustainability characteristics; as a result CIR markets are likely to expand into, for example, higher traffic routes. To further understand how to continue improving CIR for existing applications as well as future applications, better techniques are needed with regard to interfacing design and construction. Moisture is one key area in which design and construction are often disconnected. This study’s objective, therefore, was to evaluate the moisture (and associated early-age strength and stability) aspects of CIR, particularly within a framework that could consider hydraulic cement, bituminous emulsion, or combinations of both binders. A universal design framework that accommodates any binder or combination thereof while representing early-age field conditions has advantages for agencies, not only in its reasonable characterization of construction processes, but also in its facilitation of competition and creativity in the process of selecting materials and proportions. This study was organized in three phases. Phase 1 documented moisture instrumentation of a cement CIR project. Data were successfully obtained throughout compaction and curing and were used in Phases 2 and 3 alongside supplemental field and laboratory testing. Phase 2 evaluated moisture’s role in compaction; Phase 3 evaluated moisture–strength and moisture–stability relationships for various curing protocols. Phase 2 concluded that high (>6%) moisture content, typical of Proctor compaction, is generally unnecessary. Thus, Proctor compaction is discouraged in favor of a fixed design moisture content. Phase 3 concluded that humid (35% to 50% humidity) and dry 40°C oven curing protocols are candidates for universal CIR design.
Fear of Movement and Catastrophizing in Participants with Temporomandibular Disorders.

AIMS To assess differences in catastrophizing and kinesiophobia in relation to areas of pain and somatic symptoms among participants with temporomandibular disorders (TMDs) and controls. METHODS In total, 401 participants (333 women, 68 men, mean age: 45.8 years) in the TMJ Impact Project were examined in accordance with the Diagnostic Criteria for TMD, including clinical examination (Axis I) and psychosocial assessment (Axis II) augmented with imaging of the temporomandibular joint (TMJ). Of these, 218 participants had a painful TMD pain diagnosis, 63 had a nonpainful TMD diagnosis, and 111 had no TMD. Nine participants had missing data. Participants completed the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Areas of Pain figure, and the Patient Health Questionnaire-15 for assessing somatic symptoms. RESULTS Compared to controls, participants with TMD pain showed higher levels of catastrophizing (P = .017), kinesiophobia (P < .001), areas of pain (P < .001), and somatic symptoms (P < .001). Participants with nonpainful TMD showed a higher level of kinesiophobia (P < .001) than controls. There was a positive correlation between catastrophizing and kinesiophobia for participants with TMD pain (r = 0.33, P < .001) and nonpainful TMD (r = 0.42, P < .001). DISCUSSION The results suggest more fear of movement, as well as an association between catastrophizing and fear of movement, in participants with TMD pain and in participants with nonpainful TMD compared to controls. Assessment and management of fear of movement as well as catastrophizing may be useful as part of individualized treatment strategies for patients with TMD.
Switching from high‐flux dialysis to hemodiafiltration: Cost‐consequences for patients, providers, and payers

Hemodiafiltration (HDF) achieves a more efficient reduction of the uremic toxic load compared to standard high‐flux hemodialysis (HF‐HD) by virtue of the combined diffusive and convective clearances of a broad spectrum of uremic retention solutes. Clinical trials and registry data suggest that HDF improves patient outcomes. Despite the acknowledged need to improve survival rates of dialysis patients and the survival benefit HDF offers, there is little to no utilization in some countries (such as the US) in prescribing HDF to their patients. In this analysis, we present the healthcare value‐based case for HDF (relative to HF‐HD) from the patient, provider, and payor perspectives. The improved survival and reduced morbidity observed in studies conducted outside the US, as well as the reduced hospitalization, are attractive for each stakeholder. We also consider the potential barriers to greater utilization of HDF therapies, including unfounded concerns regarding additional costs of HDF, e.g., for the preparation and microbial testing of quality of substitution fluids. Ultrapure fluids are easily attainable and prepared from dialysis fluids using established “online“ (OL) technologies. OL‐HDF has matured to a level whereby little additional effort is required to safely implement it as all modern machine systems are today equipped with the OL‐HDF functionality. Countries already convinced of the advantages of HF‐HD are thus well positioned to make the transition to OL‐HDF to achieve further clinical and associated economic benefits. Healthcare systems struggling to cope with the increasing demand for HD therapies would therefore, like patients, be beneficiaries in the long term with increased usage of OL‐HDF for end stage kidney disease patients.
RNA-seq analysis identifies differentially expressed gene in different types of donkey skeletal muscles

Abstract The main component of donkey meat is skeletal muscle, and different muscle fibers have been found to be associated with meat quality. However, RNA-seq technology has yet to be used to profile the transcriptomic changes of different muscles of the donkey. In this study, the characterizations of different muscles on the gene expression profiles of Dezhou donkey were obtained, the aim was to identify the important genes in donkey muscles, and aid in improving donkey meat quality via RNA-seq. In the donkey gluteus (DG) and donkey longissimus dorsi (DL) group, GO enrichment indicated that DEGs were mainly involved in the biological regulation and metabolic process, and KEGG analysis shows that a total of 427 DEGs were mapped to 216 KEGG pathways and 23 KEGG pathways were significantly enriched such as the ribosome, glycolysis/gluconeogenesis, glucagon signaling pathway and biosynthesis of amino acids pathways. Meanwhile, 504 DEGs were mapped to 223 KEGG pathways, in which 17 were significantly enriched including cardiac muscle contraction and oxytocin signaling pathway in donkey hamstring muscles (DH) and DL group. In addition, the tenderness in donkey meat might involve muscle fiber type and glucose metabolism, which might profit from the DEGs including MYH1, MYH7, TNNC1, TNNI3, TPM3, ALDOA, ENO3, and PGK1. The genes found in this study will provide some ideas for further understanding the molecular mechanism of donkey meat quality.
Cavotricuspid isthmus ablation guided by force‐time integral – A randomized study

Force‐time integral (FTI) is an ablation marker of lesion quality and transmurality. A target FTI of 400 gram‐seconds (gs) has been shown to improve durability of pulmonary vein isolation, following atrial fibrillation ablation. However, relevant targets for cavotricuspid isthmus (CTI) ablation are lacking.
CFD investigation of indoor hygrothermal performance in academic research storage room: Measurement and validation

ABSTRACT Poor hygrothermal performance exacerbates deterioration risk from mould growth, corrosion and damage to archival materials. Improved microcomputers’ computational power has significantly advanced computational fluid dynamics (CFD) models and research developments in indoor airflow, heat transfer and contaminant transport. Nevertheless, numerous uncertainties exist in the CFD experiments which require adequate clarifications for improved results’ reliability. This paper presents the measurement and validation of a CFD model for the investigation of the hygrothermal performance in an indoor environment with known cases of microbial proliferations. The room, 5.2 m × 4.8 m × 3.0 m high, is air-conditioned and ventilated by constant air volume (CAV) system controlling the indoor airflow and hygrothermal profiles with ceiling mounted four-way supply diffuser and extract grille for indoor air distribution. The methodology combines in-situ experiment and numerical simulation with a commercial CFD tool using the standard k–e model. Microclimate and airflow parameters obtained from in-situ experiments were used as boundary conditions in the CFD. The study shows a good agreement between the predicted and measured indoor hygrothermal profile with less than 10% deviation. The results indicate that the model can be employed for further investigation with high confidence. Keywords: CFD Simulation In-situ Experiments Indoor Climate Hygrothermal performance Uncertainty Assessment