Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of User Characteristics on the Usability of a Home-Connected Medical Device (Smart Angel) for Ambulatory Monitoring: Usability Study

Background The Smart Angel home medical device allows ambulatory surgery patients to monitor their own health by taking their blood pressure and oxygen levels and answering a health questionnaire from home. Currently, this device is a prototype in the design phase, and no usability evaluation has been performed. This preventive device must be usable by patients with different profiles; however, it is important to select patients carefully to ensure their safety when using the device. As such, it would be interesting to know how to select or exclude patients. However, the links between user characteristics and the usability of this home medical device remain unclear. Objective This study aims to better understand the links between certain characteristics of potential patients (ie, age, education, technophilia, and health literacy) and the usability (ie, effectiveness, efficiency, and satisfaction) of Smart Angel, as defined by the ISO 9241-11. Methods We conducted an experimental study involving 36 participants investigating the effects of 4 patient characteristics (ie, age, education, technophilia, and health literacy) on usability, measured in terms of effectiveness, efficiency, and satisfaction. A mixed methods approach (subjective vs objective) using a variety of standard instruments was adopted (direct observation, video analysis, and questionnaires). First, to help participants project themselves into the real use of the Smart Angel device, they watched a scenario in a video. Second, the participants completed a set of questionnaires to show the extent of their health literacy level (Newest Vital Sign [NVS] and the Health Literacy Survey [HLS]) and then operated Smart Angel devices. Efficiency (ie, handling time) and effectiveness (ie, number of handling errors) measures were collected by video analysis. Satisfaction measures were collected by a questionnaire (System Usability Scale [SUS]). The qualitative observational data were coded using inductive analysis by 2 independent researchers specialized in cognitive psychology and cognitive ergonomics. Results The results show a moderate and positive correlation between age and effectiveness (r=0.359; P=.03) and efficiency (r=0.357; P=.03). There is strong correlation between health literacy scored by the NVS and effectiveness (r=0.417; P=.01), efficiency (r=-0.38; P=.02), and satisfaction (r=0.45; P=.006). However, there is a weak correlation between technophilia and usability and no relationship between education level and usability. Conclusions Our results show that literacy level and age are 2 important factors to consider when selecting future users of the Smart Angel device to ensure patient safety. This study also serves as an example promoting mixed methodologies in assessments of medical device usability that cannot be performed under real-world conditions.
Effect of clinician's experience and expertise on the inter- and intra-observer reliability of hip migration index in children with cerebral palsy

Abstract Few studies have investigated the reliability of Reimers’ hip migration percentage (RMP) in children with cerebral palsy (CP). Most studies on the topic reflected rating results of physician with a similar level of experience from the same expertise. This study aimed to determine the effect of clinician's experience and expertise on the intra-and inter-observer reliability of RMP. In this retrospective observational study, hip radiographs of children with CP were identified. 5 observers with different degrees of working experience from 3 different clinical fields, including orthopedics, radiology, and physical medicine and rehabilitation, performed all RMP measurements. All measurements were repeated 6 weeks later by the same observers. Inter- and intra-observer reliability for RMP measurements were assessed using Intraclass Correlation Coeficient (ICC), calculated from 2 sets of repeated measurements on a subset of 50 hips, with a 6 week apart for each observer. Fifty hip radiographs of 25 children with CP (10 females and 15 males; mean age: 6 years; age range: 2–8 years) were examined in the current study. No significant differences existed in intra-and inter-observer measurements. Excellent intra-observer reliability was observed between the 2 separate measurements for each observer, with a mean ICC of 0.976 (range: 0.956–0.989; P < .001). Among 5 observers, inter-observer reliability was excellent for the 2 separate RMP measurements, with the mean ICC minimally increasing between the 2 measurement periods (mean ICC: 0.928, range: 0.838–0.979 and mean ICC: 0.936, range: 0.861–0.983, respectively) (P < .001). Clinician's experience and expertise may not affect inter-and intra-observer reliability of RMP measurements.
The terrible twos: How children cope with frustration and tantrums and the effect of maternal and paternal behaviors.

Experimental Frustration Procedures with 158 children (15-39 months) of two-parent families were conducted, with each parent separately involved. We examined diverse characteristics of children's frustration and focused on specific behaviors of how children coped and parents supported them. In addition, external observers measured child attachment security (via Attachment Q Sort) toward the mother and the father during two home visits. Children with high attachment security became frustrated later and for a shorter time, and fathers, as compared to mothers, relieved these frustration patterns and reduced them. Although 22.2% children exhibited intense frustration responses up to tantrums, levels remained unaffected by child gender, but decreased with child age. Time-lag analyses revealed that children's self-comforting behaviors reduced frustration responses only by around 20%, but self-distracting (in younger children) and pretend-playing (in older children) by around 50% and 70%. Of the parent behaviors, demonstrating reduced children's frustration by up to 40% whereas distracting and reframing by around 60% (mothers) and 80% (fathers). In general, mothers tended to protect the child from distress, whereas fathers assisted the child in coping with frustration. However, if mothers soothed and fathers encouraged, children's frustration intensified.
Commentary: Posterior optic buttonholing of intraocular lens implantation through posterior capsulorrhexis margin: A technique of intraocular lens implantation in cases of anterior capsulorrhexis extension in pediatric cataract surgery

5. Vasavada AR, Vasavada V, Shah SK, Trivedi RH, Vasavada VA, Vasavada SA, et al. Postoperative outcomes of intraocular lens implantation in the bag versus posterior optic capture in pediatric cataract surgery. J Cataract Refract Surg 2017;43:1177-83. 6. Jeng BH, Hoyt CS, McLeod SD. Completion rate of continuous curvilinear capsulorhexis in pediatric cataract surgery using different viscoelastic materials. J Cataract Refract Surg 2004;30:85-8.
An X-ray diffraction study of complexes of DNA and lactosyl-functionalised liposomes induced by bivalent metal cations: coexistence of different symmetries

By using synchrotron X-ray diffraction we studied the structure and phase behaviour of complexes of DNA with the anionic 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-lactosyl (L-PE), mixed with zwitterionic lipids 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) or 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE), in aqueous solutions of Mn2+ and Ca2+. Aqueous dispersions of simple L-PE/DOPC and L-PE/DOPE in the presence and absence of metal cations were also studied. All the systems complexed in a self-assembled manner, the DNA condensation being promoted by the metal cations. These complexes are organised in a variety of structures showing a number of symmetries, sometimes coexisting, for example condensed multilamellar, L α c, inverted hexagonal, HII c , and cubic, Pn3m. Phase distribution depends on the molar ratios between L-PE and DOPC or DOPE, respectively.
Intention to Adopt mHealth Apps Among Informal Caregivers: Cross-Sectional Study

Background Caregiving responsibility can change caregivers’ lives; modify their emotions; and make them feel frustrated, fearful, and nervous, thereby imposing physical and mental stress. Caregiving-related mobile apps provide a platform for obtaining valuable and trusted information, connecting more easily with other caregivers, monitoring medications, and managing appointments, and assessing health requirements and conditions of care receivers. Such apps also incorporate valuable resources that address care for the caregivers. Despite the potential benefits of caregiving-related apps, only a limited number of caregivers have adopted and used them. Objective The aim of this study is to explore the important factors that affect caregivers’ intentions to integrate related mobile apps into their routine caregiving responsibilities. Methods Using the protection motivation theory, we conducted a cross-sectional study among 249 participants. Purposive sampling was used to target participants who met 4 inclusion criteria: US residents, owning and using a smartphone, informal caregivers (individuals who give care to a friend or family member without payment) who provided at least 8 hours of care per week in the past year, and those currently not using any mobile app for caregiving purposes. We created a survey using Qualtrics and posted it on Amazon’s Mechanical Turk website. Participants received monetary compensation after successful completion of the survey. Results We found that capabilities and skills of caregivers to use mobile apps, the app’s effectiveness in responding to the needs of caregivers, the degree of control of caregivers over their responsibilities, and the decisions they make for their care receivers can predict their willingness to adopt caregiving-related apps. In addition, the severity of health status and vulnerability of care receivers to unexpected health changes indirectly shape their caregivers’ decisions to adopt and use mobile apps for caregiving purposes. Conclusions This study explores the important factors that affect informal caregivers’ intentions to adopt related mobile apps into their routine caregiving responsibilities. The results contribute to both mobile health adoption and the caregiving literature, and they offer significant implications for developers, health care practitioners, and policy makers.
A retrospective investigation of the prodromal stages of eating disorders and use of health services in young patients the year prior to the diagnosis

The aim of this study was to analyse the characteristics and the frequency of medical consultations in the year prior to the diagnosis and the intervention onset of the Eating Disorder, as well as the different prodromal symptoms. The final aim was to understand the origin of all referrals and their possible influence on the duration of untreated illness.
Human Adipose-derived mesenchymal stem cells promote lymphocyte apoptosis and alleviate atherosclerosis via miR-125b-1-3p/BCL11B signal axis.

BACKGROUND Mesenchymal stem cells (MSCs) have shown great potential in the treatment of cardiovascular diseases, with fat being a more accessible source of MSCs. This study investigated the effect of human adipose-derived mesenchymal stem cells (hMSCs-Ad) exosomes on T lymphocytes and its role in atherosclerosis (AS). METHODS The exosomes were preliminarily isolated hMSCs-Ad and co-cultured with human H9 T lymphocytes. The effects of hMSCs-Ad exosomes on the proliferation and apoptosis of H9 were examined by performing functional experiments. The serum lipid level and inflammatory factor level in tail vein of mice were measured by biochemical analyzer and enzyme linked immunosorbent assay (ELISA) respectively. RESULTS The hMSCs-Ad-derived exosomes up-regulate the expression of micro (mi)R-125b-1-3p in H9 and AS arterial tissues. miR-125b-1-3p shared a targeted binding site with B-cell chronic lymphocytic leukemia (CLL)/lymphoma 11B gene (BCL11B). miR-125b-1-3p negatively regulated the expression of BCL11B in H9, and that knocking down BCL11B in H9 promoted its apoptosis. Injection of hMSCs-Ad-derived exosomes via the tail vein effectively reduced blood lipid and inflammatory factors, and that relieved the symptoms of AS in AS model mice. CONCLUSIONS miR-125b-1-3p was expressed in hMSCs-Ad exosomes and can promote T lymphocyte apoptosis and alleviate AS by down-regulating BCL11B expression. It provides potential molecular targets for the clinical treatment of AS.
Checklist for Early Recognition and Treatment of Acute Illness and Injury: An Exploratory Multicenter International Quality-Improvement Study in the ICUs With Variable Resources

Supplemental Digital Content is available in the text. OBJECTIVES: To determine whether the “Checklist for Early Recognition and Treatment of Acute Illness and Injury” decision support tool during ICU admission and rounding is associated with improvements in nonadherence to evidence-based daily care processes and outcomes in variably resourced ICUs. DESIGN, SETTINGS, PATIENTS: This before-after study was performed in 34 ICUs (15 countries) from 2013 to 2017. Data were collected for 3 months before and 6 months after Checklist for Early Recognition and Treatment of Acute Illness and Injury implementation. INTERVENTIONS: Checklist for Early Recognition and Treatment of Acute Illness and Injury implementation using remote simulation training. MEASUREMENTS AND MAIN RESULTS: The coprimary outcomes, modified from the original protocol before data analysis, were nonadherence to 10 basic care processes and ICU and hospital length of stay. There were 1,447 patients in the preimplementation phase and 2,809 patients in the postimplementation phase. After adjusting for center effect, Checklist for Early Recognition and Treatment of Acute Illness and Injury implementation was associated with reduced nonadherence to care processes (adjusted incidence rate ratio [95% CI]): deep vein thrombosis prophylaxis (0.74 [0.68–0.81), peptic ulcer prophylaxis (0.46 [0.38–0.57]), spontaneous breathing trial (0.81 [0.76–0.86]), family conferences (0.86 [0.81–0.92]), and daily assessment for the need of central venous catheters (0.85 [0.81–0.90]), urinary catheters (0.84 [0.80–0.88]), antimicrobials (0.66 [0.62–0.71]), and sedation (0.62 [0.57–0.67]). Analyses adjusted for baseline characteristics showed associations of Checklist for Early Recognition and Treatment of Acute Illness and Injury implementation with decreased ICU length of stay (adjusted ratio of geometric means [95% CI]) 0.86 [0.80–0.92]), hospital length of stay (0.92 [0.85–0.97]), and hospital mortality (adjusted odds ratio [95% CI], 0.81 (0.69–0.95). CONCLUSIONS: A quality-improvement intervention with remote simulation training to implement a decision support tool was associated with decreased nonadherence to daily care processes, shorter length of stay, and decreased mortality.
The Phenomenological Functions that Characterize the Surface Free Energy Density of Nematic Liquid Crystals: A Microscopic Analysis

In a recent paper, Faetti proposed a new phenomenological expression for the surface free energy density Fs of a nematic liquid crystal m contact with an isotropic substrate. Fs depends on director n, on the unit vector k orthogonal to the interface and on their gradients at the interface. Five different terms appear in the expression of Fs. The first term is the standard anchoring energy contribution, the second and third terms are elastic contributions that depend on the surface tangential director gradients, the fourth and fifth terms are new geometrical contributions that account for the effect of a local curvature of the interfaces. The expression of the surface free energy density is characterized by five phenomenological functions W(nk), K13(nk), K14(nk), Ai(nk) and A2(nk) where nk is the scalar product n. k. In this paper we give the first microscopic calculation of these new surface functions by using a simplified microscopic model of intermolecular interactions. Surface functions Ai(nk), A2(nk), and K14(nk) are found to be of the same order of magnitude of the Frank bulk elastic constants, whilst K13(nk) = 0. The geometric surface functions Ai(nk) and A2(nk) satisfy the simple relation Ai(nk) = -n( A2(nk). Both the results K13(nk) = 0 and Ai(nk) = -n( A2(nk) are shown to be a direct consequence of the invariance with respect to the transform n - -n of the interaction energy between molecules.
RENAL CLEARANCE AND URINARY EXCRETION OF CIPROFLOXACIN IN LOHI SHEEP

This study was undertaken with objective to investigate the renal clearance and urinary excretion of ciprofloxacin in eight sheep of Lohi breed. Ciprofloxacin was administered at the rate of 5 mg/kg body weight intramuscularly, to each of eight animals. After administration of drug, blood and urine samples were drawn at various time intervals and concentrations of ciprofloxacin and creatinine were analyzed using high performance liquid chromatography (HPLC) and creatinine kits, respectively. The renal clearance of endogenous creatinine was recorded to be 1.33 ± 0.35 ml/min/kg. Ciprofloxacin’s renal clearance was 0.39 ± 0.06 ml/min/kg and the ratio between renal clearance of ciprofloxacin and that of creatinine remained less than one, indicating back diffusion. Ciprofloxacin excreted into the urine of sheep during 10 hours, as cumulative percentage of intramuscular dose administered, was 11.26 ± 1.74 percent. These results clearly indicated that back diffusion was also involved in renal handling of drug along with glomerular filtration. Based on these results, we concluded that glomerular filtration rate (GFR) was lower in local sheep as compared to their foreign counterparts.
A comprehensive review on phenolic compounds from edible mushrooms: Occurrence, biological activity, application and future prospective

Abstract Phenolic compounds are minor metabolites usually present in mushroom species. Because of their potential advantages for human health, such as antioxidant and other biological activities, these bioactive components have been gaining more interest as functional foods, nutraceutical agents for providing better health conditions. This review aims to comprehensively discuss the recent advances in mushroom phenolic compounds, including new sources, structural characteristics, biological activities, potential uses and its industrial applications as well as the future perspectives. Phenolic acids as well as flavonoids are considered the most common phenolics occurring in mushroom species. These are responsible for its bioactivities, including antioxidant, anti-inflammatory, antitumor, antihyperglycaemic, antiosteoporotic, anti-tyrosinase and antimicrobial activities. Several edible mushroom species with good phenolic content and show higher biological activity were highlighted, in a way for its futuristic applications. Trends on mushroom research highlighting new research areas, such as nanoformulation were discussed. Furthermore, the use of phenolic compounds as nutraceutical and cosmeceutical agents as well as the future perspectives and recommendations were made.
On the use of the merging R factor as a quality indicator for X-ray data

By comparison of the accuracy and the merging R factor (Rmerge) of artificially created X-ray data sets, it is demonstrated that Rmerge is a poor predictor for the precision of X-ray data. The more often a given reflection is observed, the more precise the average intensity is, whereas Rmerge has a tendency to be higher at higher data redundancy.
Adherence to risk-assessment protocols to guide computed tomography pulmonary angiography in patients with suspected pulmonary embolism

Abstract Aims The use of computed tomography pulmonary angiography (CTPA) in the detection of pulmonary embolism (PE) has considerably increased due developing technology and better availability of imaging. The underuse of pre-test probability scores and overuse of CTPA has been previously reported. We sought to investigate the indications for CTPA at a University Hospital emergency clinic and seek for factors eliciting the potential overuse of CTPA. Methods and results Altogether 1001 patients were retrospectively collected and analysed from the medical records using a structured case report form. PE was diagnosed in 222/1001 (22.2%) of patients. Patients with PE had more often prior PE/deep vein thrombosis, bleeding/thrombotic diathesis and less often asthma, chronic obstructive pulmonary disease, coronary artery disease, or decompensated heart failure. Patients were divided into three groups based on Wells PE risk-stratification score and two groups based on the revised Geneva score. A total of 9/382 (2.4%), 166/527 (31.5%), and 47/92 (52.2%) patients had PE in the CTPA in the low, intermediate, and high pre-test likelihood groups according to Wells score, and 200/955 (20.9%) and 22/46 (47.8%) patients had PE in the CTPA in the low-intermediate and the high pre-test likelihood groups according to the revised Geneva score, respectively. D-dimer was only measured from 568/909 (62.5%) and 597/955 (62.5%) patients who were either in the low or the intermediate-risk group according to Wells score and the revised Geneva score. Noteworthy, 105/1001 (10.5%) and 107/1001 (10.7%) of the CTPAs were inappropriately ordered according to the Wells score and the revised Geneva score. Altogether 168/1001 (16.8%) could theoretically be avoided. Conclusions This study highlights scant utilization of guideline-recommended risk-stratification tools in CTPA use at the emergency department.
Severity of Illness and Predictive Models in Society of Critical Care Medicine’s First 50 Years: A Tale of Concord and Conflict

Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. 728 www.ccmjournal. org May 2021 • Volume 49 • Number 5 DOI: 10.1097/CCM.0000000000004924 Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Impact of a Longitudinal Faculty Development Program on the Quality of Multiple-Choice Question Item Writing in Medical Education

Background: Like many other academic programs, medical education is incomplete without a robust assessment plan. Objective: The study aimed to evaluate the impact of longitudinal faculty development program (FDP) on the examination item quality (EIQ) from a cohort of medical college faculty members. Methods: Item analysis (IA) of multiple-choice questions (MCQs) from a cohort of medical tutors over a 3-year period (2017 [S1], 2018 [S2], and 2019 [S3]) before and following once-per-week FDP was conducted. The questions were from three randomly selected courses: man and his environment (MEV) from phase 1, central nervous system (CNS) from phase 2, and internal medicine (MED) from phase 3. Data assessed were 480 MCQs from the final exams in the courses. The parameters considered in IA were the difficulty index, index of discrimination, nonfunctional distractors (NFDs), distractor efficiency for each question item, and Cronbach's alpha (CA) for the test as a whole. Comparison over the 3 years was made using Fisher's exact test and repeated-measures ANOVA with Bonferroni test as post hoc test. Results: Overall, out of 480 MCQs, 272 had no NFD (52 [19.52%], 104 [38.24%], and 116 [42.65%] in 2017, 2018, and 2019, respectively) with a significant difference between S3, S2, and S1 (P < 0.0001). The mean CA for the exams in S1, S2, and S3, respectively, were 0.51, 0.77, and 0.84, P < 0.0001. Conclusion: There was an improvement in EIQ following the implementation of longitudinal FDP. Thus, the need for active training and retraining of the faculty for a better EIQ cannot be overemphasized.