Miracle-dz/UniFAR-FTUs huggingface dataset:
Managing the Chronic : Investigating chronic disease management in the Netherlands

markdownabstractThis thesis is based on research conducted on twenty-two disease management programs in the Netherlands. These programs were predominantly based in primary care facilities and focused on chronic diseases including diabetes, COPD, risk of cardiovascular disease, mental health issues, or co-morbidity for patients with multiple chronic diseases. The disease management programs were carried out by teams of clinicians and were supported by internal and external communication and chronic disease experts. As part of the programs, patients were invited to participate in extra educational sessions, offered additional appointments to discuss their concerns with their chronic disease, and/or given access to their medical record via an online patient portal; through the disease management programs, much emphasis was put on partnering with patients to manage their chronic disease. To understand how these disease management programs worked in practice, I conducted interviews with clinicians, patients, and external supporters; I also conducted online data collection of a patients’ support website to get further observations and deeper insight into the lives of those with a chronic disease. This research uncovers how the programs changed the lives of those who participated in them, and how disease management programs changed care in the programs. It also reveals how the research program that ran alongside the disease management program impacted healthcare delivery.
Multi-drug resistant bacteria predict mortality in bloodstream infection in a tertiary setting in Tanzania

Background Bloodstream infections (BSI) are serious and life-threatening, associated with high mortality and morbidity. In resource-limited settings, there is a paucity of data on predictors of outcome in patients with BSI. This study aimed at examining the predictors of mortality in patients with BSI as well as bacteria causing BSI. Methods and materials This was a cross-sectional study conducted at Muhimbili National Hospital between April and May 2018. Blood culture results from all inpatients at the clinical microbiology laboratory were recorded and clinical information was retrieved retrospectively from the files. Bacteria from positive blood culture were identified and antimicrobial susceptibility was performed. Results The overall prevalence of BSI was, 46/402 (11.4% 95% CI 8.6–15), with a case fatality rate of 37%. There was a significantly high rate of BSI in patients who had died (19.5%) compared to those who survived (9.2%) p = 0.008. Gram-negative bacteria (74%) were the common cause of BSI, with a predominance of Enterobacteriaceae (22), followed by Pseudomonas aeruginosa (11). The majority of bacteria (70.5%) isolated from patients with BSI were Multi-drug resistant (MDR). Forty-six percent of Pseudomonas aeruginosa were resistant to meropenem while 68% (15/22) of Enterobacteriaceae were extended-spectrum β lactamase producers. Carbapenemase production was detected in 27% (3/11) of Pseudomonas aeruginosa and one Proteus mirabilis. Forty percent of Staphylococcus aureus were methicillin-resistant Staphylococcus aureus. Positive blood culture (aOR 2.24, 95%CI 1.12–4.47, p 0.02) and admission to the intensive care unit (aOR 3.88, 95%CI 1.60–9.41, p = 0.003) were independent factors for mortality in suspected BSI. Isolation of MDR bacteria was an independent predictor for mortality in confirmed BSI (aOR 15.62, 95%CI 1.24–161.38, p = 0.02). Conclusion The prevalence of BSI was 11.4%, with the majority of bacteria in BSI were MDR. Positive blood culture, admission to the ICU and MDR were predictors for mortality.
Mexican-origin family members' unique and shared family perspectives of familism values and their links with parent-youth relationship quality.

To advance understanding of parents' and adolescents' unique and shared perspectives of familism, a core cultural value in Mexican-origin families, our study addressed 2 goals. First, we identified family members' unique and shared perspectives of familism values using multitrait-multimethod confirmatory factor analysis (Kenny & Kashy, 1992). Second, we examined links between family members' unique and shared perspectives of familism values and mother-youth and father-youth warmth and conflict. Participants were mothers, fathers, and 2 siblings (Mage = 15.48 years for older and Mage = 12.55 years for younger siblings) from 246 Mexican-origin families who were interviewed in their homes on 2 occasions over 5 years. Results indicated that familism values operated as an individual-level process more so than a family-level process and that youth's familism values were most consistently linked to parent-youth relationship quality. These findings provide novel insights into investigating family system dynamics involving familism values, suggest that youth's familism values may keep them connected to their families during adolescence, and highlight potential implications for prevention and intervention programs geared toward Mexican-origin families. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Parental Understanding of Research Consent Forms in the PICU: A Pilot Study*

Supplemental Digital Content is available in the text. Objectives: To describe legal guardians’ understanding of key concepts in a research consent form presented within 24 hours of their child’s admission to the PICU and to explore legal guardians’ opinions of the format (language, length) of the consent form and the overall consent process. Design: Single-center, exploratory pilot study. Setting: PICU at a tertiary-care hospital in Canada. Subjects: Forty-one English- and French-speaking legal guardians of children less than 18 years old, who had been admitted to the PICU within the past 24 hours and were expected to stay at least 48 hours, between October 2018 and February 2019. Interventions: The consent form from a previous PICU trial was given and explained to legal guardians within 24 hours of their child’s admission to the PICU. Measurements and Main Results: Legal guardians’ understanding of key concepts in the consent form was evaluated using a questionnaire the day after the form was explained, and opinions were collected verbally and using an additional survey. The median number of questions answered incorrectly was three of seven (interquartile range = 2–4). Participants best understood the topic of the study (5% incorrect), but 80% of participants were unable to recall a single risk. The median rating of the language in the form was five of five (very easy to understand; interquartile range = 4–5), and 88% of participants said it was a reasonable length. Conclusions: Despite positive opinions of the consent form, most legal guardians did not understand all key components of the consent information provided to them orally and in writing within 24 hours of their child’s PICU admission. Future studies are required to determine barriers to understanding and explore alternative approaches to obtaining consent in this setting.
A mobile application to monitor mode, content and duration of health navigation services for people living with HIV in Guatemala

ABSTRACT Health navigation is increasingly being used to support people living with HIV, but timely monitoring of navigation is challenging due to the burden of reporting a high volume of diverse activities. We designed a mobile application (app) for navigators to report their interactions with men who have sex with men living with HIV (n = 374), including: (1) mode of support; (2) content; and (3) duration. We assessed sociodemographic and behavioral characteristics of the study sample and calculated monitoring system indicators. We also conducted qualitative interviews with navigators (n = 7) and used thematic analysis to assess app acceptability and usability. From January 2017 to June 2018, 95.3% of participants interacted with their navigator at least one time and 4281 reports were recorded by nine navigators. The median number of interactions per participant was 10 (range: 1–46). The majority of interactions (71.6%) occurred remotely. Most frequently covered topics included: appointment reminders (36.9%), employment (19.9%), and family (15.5%). Navigators indicated that the system was easy to use, but some did not use it in real time as intended. Timely access to navigator data enabled feedback and continuous training. These data can also facilitate analysis of intensity and content of interactions to improve tailoring and sustainability.
Epilepsia Partialis Continua as an Early Sign of Anti-Myelin Oligodendrocyte Glycoprotein Antibody-positive Encephalitis

Anti-myelin oligodendrocyte glycoprotein (MOG) antibodies have been associated with steroid-responsive cortical encephalitis and comorbid generalized epilepsy. A 44-year-old woman developed repeated epilepsia partialis continua (EPC) without generalized seizures and was anti-MOG antibody-positive. Radiological abnormalities were detected in the bilateral medial frontoparietal cortices, but there were no cerebrospinal fluid abnormalities. She achieved remission with anti-epileptic drugs alone. However, encephalitis recurred four months later when pleocytosis appeared, and steroid therapy was effective. Altogether, EPC without typical cerebrospinal fluid features can be an early sign of anti-MOG antibody-positive encephalitis. Thus, patients with EPC of unknown etiology need to be screened for anti-MOG antibodies.
Recent advances in diagnostic technologies in lung cancer

The increase in lung cancer incidence of Korea has been dampened since 2000; however, increased human lifespan, interest in health care and the widespread implementation of health examinations have resulted in a considerable rise in detection of small lesions that need to be differentiated from lung cancer. Detection of lung cancer at an early stage rather than at a symptomatic advanced stage is also increasing, suggesting that there are increasing diagnostic demands for small peripheral lung lesions. The development of new molecular diagnostics, including next generation sequencing, companion diagnostics that accompany development of new anti-cancer drugs, and re-biopsy for application of new therapeutic modality accelerate the development of lung cancer diagnostics. In this review, we extensively describe the current available diagnostic tools in lung cancer.
Structural basis for the recognition of SARS-CoV-2 by full-length human ACE2

How SARS-CoV-2 binds to human cells Scientists are racing to learn the secrets of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2), which is the cause of the pandemic disease COVID-19. The first step in viral entry is the binding of the viral trimeric spike protein to the human receptor angiotensin-converting enzyme 2 (ACE2). Yan et al. present the structure of human ACE2 in complex with a membrane protein that it chaperones, B0AT1. In the context of this complex, ACE2 is a dimer. A further structure shows how the receptor binding domain of SARS-CoV-2 interacts with ACE2 and suggests that it is possible that two trimeric spike proteins bind to an ACE2 dimer. The structures provide a basis for the development of therapeutics targeting this crucial interaction. Science, this issue p. 1444 Insight into how SARS-CoV-2 binds its human receptor could provide a basis for the development of therapeutics. Angiotensin-converting enzyme 2 (ACE2) is the cellular receptor for severe acute respiratory syndrome–coronavirus (SARS-CoV) and the new coronavirus (SARS-CoV-2) that is causing the serious coronavirus disease 2019 (COVID-19) epidemic. Here, we present cryo–electron microscopy structures of full-length human ACE2 in the presence of the neutral amino acid transporter B0AT1 with or without the receptor binding domain (RBD) of the surface spike glycoprotein (S protein) of SARS-CoV-2, both at an overall resolution of 2.9 angstroms, with a local resolution of 3.5 angstroms at the ACE2-RBD interface. The ACE2-B0AT1 complex is assembled as a dimer of heterodimers, with the collectrin-like domain of ACE2 mediating homodimerization. The RBD is recognized by the extracellular peptidase domain of ACE2 mainly through polar residues. These findings provide important insights into the molecular basis for coronavirus recognition and infection.
Innate inflammatory response to acute inhalation exposure of riot control agent oleoresin capsicum in female rats: An interplay between neutrophil mobilization and inflammatory markers

Abstract Aim: The use of oleoresin capsicum (OC) sprays, due to their irreversible health effects has now grown into a matter of heated debate. In the present study, the early phase pulmonary events involving chemotactic and inflammatory mediators after short-exposure duration to OC have been presented. Materials and methods: Female Wistar rats used in the evaluation of respiratory parameters at 1 h, 3 h, and 24 h post-exposure, were sacrificed for the evaluation of blood cell counts, BALF cytokine estimation, lung capillary leakage, study of oxidative stress and histopathology of the lungs. Results: Results confirmed a dose-dependent effect of OC exposure on serum clinical chemistry and hematological parameters. Subsequent upregulation of IL-l and TNF-α indicated lung’s responses to acute oxidant-induced injury and inflammation after OC exposure. Significant alterations in the pulmonary levels of reactive oxygen intermediates were seen following the inhalation of OC. Infiltration of polymorphonuclear leukocytes, mostly neutrophils, into the site of infection was evident in the cytocentrifuged samples of BALF. Histological samples of rat lung sections revealed the recruitment of inflammatory cells in the airways and around blood vessels in the subepithelium of conducting airways. Conclusion: Results of the present study demonstrated that, exposure to OC spray may mitigate inflammatory response and development of acute lung injury in rats. However, it can be concluded that although OC spray causes pulmonary hazards in the aforementioned concentrations, it can be used as a non-lethal riot control agent in minimal concentration. Understanding the in-depth mechanism of action in the molecular and receptor level will help in developing effective antagonist against OC.
‘We need other men to stand up and start the journey’ engaging men as HIV community health workers - a gender transformative approach?

Abstract The HIV epidemic is strongly gendered. Women and girls are more likely to contract HIV for biological and social reasons in Sub-Saharan Africa and men living with HIV are more likely to be lost to follow-up and die on antiretroviral therapy (ART) than women. Care work is also gendered, with women shouldering the burden of HIV care-related work. This paper considers the potential of male delivered community health work to improve men’s HIV-related health outcomes and shift gendered norms related to care work. It describes the experiences and perspectives of eight HIV community health workers and their clients from the Cape Town area, and reviews current evidence on male-focused HIV and sexual and reproductive health services, gender transformation and men and care. Findings suggest that meaningfully involving more men in HIV care work may be a way to shift damaging hegemonic masculine norms related to care and health, and that South Africa’s roll-out of National Health Insurance could be an opportunity to do so. Barriers to engaging men in this feminised profession are also explored.
Short stature explained by dimerization of human growth hormone induced by a p.C53S point mutation

A homozygous mutation in growth hormone 1 (GH1) was recently identified in an individual with growth failure. This mutation, c.705G>C, causes replacement of cysteine at position 53 of the 191-amino-acid sequence of 22 kDa human GH (hGH) with serine (p.C53S). This hGH molecule (hereafter referred to as GH-C53S) lacks the disulfide bond between p.Cys-53 and p.Cys-165, which is highly conserved among species. It has been reported previously that monomeric GH-C53S has reduced bioactivity compared with WT GH (GH-WT) because of its decreased ability to bind and activate the GH receptor in vitro. In this study, we discovered that substitution of p.Cys-53 in hGH significantly increased formation of hGH dimers in pituitary cells. We expressed His-tagged hGH variants in the cytoplasm of genetically modified Rosetta-gami B DE3 Escherichia coli cells, facilitating high-yield production. We observed that the bioactivity of monomeric GH-C53S is 25.2% of that of GH-WT and that dimeric GH-C53S–His has no significant bioactivity in cell proliferation assays. We also found that the expression of GH-C53S in pituitary cells deviates from that of GH-WT. GH-C53S was exclusively stained in the Golgi apparatus, and no secretory granules formed for this variant, impairing its stimulated release. In summary, the unpaired Cys-165 in GH-C53S forms a disulfide bond linking two hGH molecules in pituitary cells. We conclude that the GH-C53S dimer is inactive and responsible for the growth failure in the affected individual.
Storm impacts on phytoplankton community dynamics in lakes

In many regions across the globe, extreme weather events such as storms have increased in frequency, intensity, and duration due to climate change. Ecological theory predicts that such extreme events should have large impacts on ecosystem structure and function. High winds and precipitation associated with storms can affect lakes via short‐term runoff events from watersheds and physical mixing of the water column. In addition, lakes connected to rivers and streams will also experience flushing due to high flow rates. Although we have a well‐developed understanding of how wind and precipitation events can alter lake physical processes and some aspects of biogeochemical cycling, our mechanistic understanding of the emergent responses of phytoplankton communities is poor. Here we provide a comprehensive synthesis that identifies how storms interact with lake and watershed attributes and their antecedent conditions to generate changes in lake physical and chemical environments. Such changes can restructure phytoplankton communities and their dynamics, as well as result in altered ecological function (e.g., carbon, nutrient and energy cycling) in the short‐ and long‐term. We summarize the current understanding of storm‐induced phytoplankton dynamics, identify knowledge gaps with a systematic review of the literature, and suggest future research directions across a gradient of lake types and environmental conditions.
A Rail Fastener Tightness Detection Approach Using Multi-source Visual Sensor

At present, the method of two-dimensional image recognition is mainly used to detect the abnormal fastener in the rail-track inspection system. However, the too-tight-or-too-loose fastener condition may cause the clip of the fastener to break or loose due to the high frequency vibration shock, which is difficult to detect from the two-dimensional image. In this practical application background, 3D visual detection technology provides a feasible solution. In this paper, we propose a fundamental multi-source visual data detection method, as well as an accurate and robust fastener location and nut or bolt segmentation algorithm. By combining two-dimensional intensity information and three-dimensional depth information generated by the projection of line structural light, the locating of nut or bolt position and accurate perception of height information can be realized in the dynamic running environment of railway. The experimental results show that the static measurement accuracy in the vertical direction using the structural light vision sensor is 0.1 mm under the laboratory condition, and the dynamic measurement accuracy is 0.5 mm under the dynamic train running environment. We use dynamic template matching algorithm to locate fasteners from 2D intensity map, which achieves 99.4% accuracy, then use the watershed algorithm to segment the nut and bolt from the corresponding depth image of located fastener. Finally, the 3D shape of the nut and bolt is analyzed to determine whether the nut or bolt height meets the local statistical threshold requirements, so as to detect the hidden danger of railway transportation caused by too loose or too tight fasteners.
Assessing diet in a university student population: a longitudinal food card transaction data approach

Abstract Starting university is an important time with respect to dietary changes. This study reports a novel approach to assessing student diet by utilising student-level food transaction data to explore dietary patterns. First-year students living in catered accommodation at the University of Leeds (UK) received pre-credited food cards for use in university catering facilities. Food card transaction data were obtained for semester 1, 2016 and linked with student age and sex. k-Means cluster analysis was applied to the transaction data to identify clusters of food purchasing behaviours. Differences in demographic and behavioural characteristics across clusters were examined using χ2 tests. The semester was divided into three time periods to explore longitudinal changes in purchasing patterns. Seven dietary clusters were identified: ‘Vegetarian’, ‘Omnivores’, ‘Dieters’, ‘Dish of the Day’, ‘Grab-and-Go’, ‘Carb Lovers’ and ‘Snackers’. There were statistically significant differences in sex (P < 0·001), with women dominating the Vegetarian and Dieters, age (P = 0·003), with over 20s representing a high proportion of the Omnivores and time of day of transactions (P < 0·001), with Dieters and Snackers purchasing least at breakfast. Many students (n 474, 60·4 %) changed dietary cluster across the semester. This study demonstrates that transactional data present a feasible method for dietary assessment, collecting detailed dietary information over time and at scale, while eliminating participant burden and possible bias from self-selection, observation and attrition. It revealed that student diets are complex and that simplistic measures of diet, focusing on narrow food groups in isolation, are unlikely to adequately capture dietary behaviours.
Performance Status Is Associated With Survival in Elderly Patients Irradiated for Cerebral Metastases from Prostate Cancer

Background/Aim: Treatment of elderly patients with cancer has increasing importance. Since many of these patients may not tolerate standard treatments, they might benefit from personalized approaches. This study was performed to identify characteristics that allow estimation of survival in elderly patients with prostate cancer with cerebral metastases. Patients and Methods: Data of 21 elderly patients (≥65 years) receiving whole-brain radiotherapy (WBRT) for cerebral metastases from prostate cancer were retrospectively evaluated. Six characteristics were investigated: WBRT program, age, Karnofsky performance score (KPS), number of brain metastases, extra-cerebral metastases, and interval between diagnosis of prostate cancer and WBRT. Results: On univariate analyses, KPS ≥80% resulted in better survival than KPS ≤70% (log-rank p=0.018). Three-month survival was 60% vs. 36%, and 6-month survival 50% vs. 0%, respectively. In the Cox model, KPS maintained significance (hazard ratio=3.18, p=0.031). Conclusion: KPS is a significant prognostic factor of survival in elderly patients with prostate cancer receiving WBRT for cerebral metastases.