Miracle-dz/UniFAR-FTUs huggingface dataset:
Neuregulin 4 (NRG4) – the hormone with clinical significance in gestational diabetes mellitus

Abstract This study aimed at determining the association between serum neuregulin 4 (NRG4) and insulin in gestational diabetes mellitus (GDM) and their correlation with other metabolic parameters. A cross-sectional study was conducted from June 2018 to February 2019 at Ziauddin University, Karachi. Pregnant women (n = 80), at 24–28 weeks of gestation, were recruited. Demographic data, anthropometric measurements and antenatal history were recorded. The fasting blood was drawn for testing fasting blood sugar (FBS), NRG4, insulin and lipid profile. The subjects were evaluated for glucose challenge test after 50 g glucose ingestion. NRG4 levels (1.00 ± 0.15) were found significantly high (p < .04) in healthy group compared to GDM (0.95 ± 0.11). In GDM females, high levels for FBS (p < .02) and cholesterol (p < .03) were observed. Homeostatic model assessment of insulin resistance (HOMA-IR) had direct weak association with NRG4, inverse relationship with cholesterol and LDL but significant association (p < .05) with insulin. Significantly high NRG4 in healthy females suggests its potential role in regulating insulin sensitivity. Impact Statement What is already known on this subject? Neuregulin 4 (NGR4) is a batokine which plays a potential role in regulating insulin sensitivity, maintaining energy and metabolic homeostasis. Due to its role in lipid and glucose homeostasis, some studies report its role in gestational diabetes mellitus (GDM) but the results were controversial. What do the results of this study add? The study showed that NGR4 levels were significantly low in GDM subjects. Other metabolic factors especially insulin and homeostatic model assessment of insulin resistance (HOMA-IR) were found associated significantly (p < .05) with NGR4. What are the implications of these findings for clinical practice and/or further research? NGR4 can be a potential biomarker for gestational diabetes. Nevertheless, in order to confirm these findings, further studies, with bigger sample size are required to further ascertain the prospects of NRG4 as a potential biomarker for gestational diabetes.
Hupertimines A–E, Fawcettimine‐Type Lycopodium Alkaloids from Huperzia serrata

Five new fawcettimine‐type Lycopodium alkaloids, hupertimines A–E (1–5), were discovered from the whole plant of Huperzia serrata, along with two known alkaloids, 8α‐hydroxyphlegmariurine B (6) and 8β‐hydroxyphlegmariurine B (7). The structures of 1–7 were identified through HR‐MS, IR, 1H, 13C, and 2D NMR, and single‐crystal X‐ray diffraction analysis. Structurally, compound 1 was the fourth example of Lycopodium alkaloid with an ether linkage between C‐5 and C‐13 and 2 was the third example of Lycopodium alkaloid with a 5/5/5/5/6 pentacyclic ring system and featuring a 1‐aza‐7‐oxabicyclo[2.2. 1]heptane unit. Compounds 1–7 were tested for their BACE1 inhibitory activity. In addition, the correct 1H‐ and 13C‐NMR data for 7 were reported in current study.
Graduate students locked down? PhD students’ satisfaction with supervision during the first and second COVID-19 lockdown in Belgium

Background Supervisor support is crucial for the successful and timely completion of the PhD and the largest contributor to PhD students’ overall job satisfaction. The COVID-19 pandemic affected PhD students’ life substantially through delayed experiments, missed timelines, running out of funding, change to online team- and supervisor meetings, mandatory working from home, and social confinement. Aim This contribution considers PhD students’ satisfaction scores to reflect the extent to which PhD students felt supported by their supervisor during the COVID-19 pandemic so far and aims to investigate to what extent did PhD students’ satisfaction with supervisor support changed over time. Method It uses two longitudinal two cohorts of wave 4 to 5 of the PhD Survey at a Belgian university. These cohorts are representative of two different ways the COVID-19 pandemic might have impacted doctoral research. Cohort 1 (n = 345) includes a pre-COVID measurement (April-May 2019) and a measurement immediately after the start of the abrupt lockdown in April-May 2020. Cohort 2 (n = 349) includes the measurement at the onset of the pandemic in 2020 and after a year with continuously changing containment policies (April-May 2021). The composite measure of satisfaction with supervisor support is based on six items with high internal consistency. Results No significant net effect of time was revealed. Instead within subject interactions with time showed that in cohort 1, PhD students at the start of their PhD trajectory and PhD students with family responsibilities reported lower supervisor satisfaction scores over time. In cohort 2, PhD students not pursuing academic careers reported lower satisfaction scores over time. Conclusion In times of crises, special attention needs to be paid to PhD students who are extra susceptible to uncertainties because of their junior status or personal situation, and especially those PhD students for whom doctoral research is not a trajectory to position themselves in academia.
Quantifying Rheumatoid Arthritis Disease Activity using a Multimodal Sensing Knee Brace

Objective: Rheumatoid arthritis (RA) is a chronic inflammatory syndrome that features painful and destructive joint disease. Aggressive disease-modifying treatment can result in reduced symptoms and protection from irreversible joint damage; however, assessment of treatment efficacy is currently based largely on subjective measures of patient and physician impressions. In this work, we address this compelling need to provide an accurate and quantitative capability for monitoring joint health in patients with RA. Methods: Joint acoustic emissions (JAEs), electrical bioimpedance (EBI), and kinematics were measured noninvasively from 11 patients with RA over the course of three weeks using a custom multimodal sensing brace, resulting in 49 visits with JAE recordings and 43 with EBI recordings. Features derived from all sensing modalities were fed into a linear discriminant analysis (LDA) model to predict disease activity according to the validated disease activity index (the DAS28-ESR). Erythrocyte sedimentation rate (ESR) was predicted using ridge regression and classified into a high or low class using LDA. Results: DAS28-ESR level was predicted with an area under the receiver operating characteristic curve (AUC) of 0.82. With JAEs alone, we were able to track intrasubject differences in the disease activity score as well as classify ESR level with an AUC of 0.93. The majority of patients reported both an interest and ability to use the brace at home for longitudinal monitoring. Conclusion: This work demonstrates the ability to detect RA disease activity using noninvasive sensing. Significance: This system has the potential to improve RA disease activity monitoring by giving treating clinicians objective data that can be acquired independent of a face-to-face clinic visit.
Association of income and educational levels with adherence to direct oral anticoagulant therapy in patients with incident atrial fibrillation: A Finnish nationwide cohort study

Low socioeconomic status has been associated with poor outcomes in patients with atrial fibrillation (AF). However, little is known about socioeconomic disparities in adherence to stroke prevention with direct oral anticoagulants (DOACs). We assessed the hypothesis that AF patients with higher income or educational levels have better adherence to DOACs in terms of treatment implementation and persistence. The used nationwide registry‐based FinACAF cohort covers all patients with incident AF starting DOACs in Finland during 2011–2018. The implementation analyses included 74 222 (mean age 72.7 ± 10.5 years, 50.8% female) patients, and persistence analyses included 67 503 (mean age 75.3 ± 8.9 years, 53.6% female) patients with indication for permanent anticoagulation (CHA2DS2‐VASc score >1 in men and >2 in women). Patients were divided into income quartiles and into three categories based on their educational attainment. Therapy implementation was measured using the medication possession ratio (MPR), and patients with MPR ≥0.90 were defined adherent. Persistence was measured as the incidence of therapy discontinuation, defined as the first 135‐day period without DOAC purchases after drug initiation. Patients with higher income or education were consistently more likely adherent to DOACs in the implementation phase (comparing the highest income or educational category to the lowest: adjusted odds ratios 1.18 (1.12–1.25) and 1.21 (1.15–1.27), respectively). No association with income or educational levels was observed on the incidence of therapy discontinuation. In conclusion, we observed that income and educational levels both have independent positive association on the implementation of DOAC therapy but no association on therapy persistence in patients with AF.
Optimal unplanned design modification in adaptive two‐stage trials

Adaptive planning of clinical trials allows modifying the entire trial design at any time point mid‐course. In this paper, we consider the case when a trial‐external update of the planning assumptions during the ongoing trial makes an unforeseen design adaptation necessary. We take up the idea to construct adaptive designs with defined features by solving an optimization problem and apply it to the situation of unplanned design reassessment. By using the conditional error principle, we present an approach on how to optimally modify the trial design at an unplanned interim analysis while at the same time strictly protecting the type I error rate. This linking of optimal design planning and the conditional error principle allows sound reactions to unforeseen events that make a design reassessment necessary.
Effects of loblolly pine (Pinus taeda) and switchgrass (Panicum virgatum) intercropping techniques on intermittent stream macroinvertebrate communities

Forestry management activities can influence hydrologic regimes of intermittent streams which can influence the macroinvertebrate community of these streams. To test the effects of various harvesting and intercropping techniques, five small watersheds (0.08-0.25 km 2 ) in Greene County, AL have been monitored before and after various treatments. Modified rapid bioassesment protocols were used to sample each stream every two weeks prior to treatments and once a month following treatments. In an effort to capture the full seasonality of these intermittent streams, samples were collected for a full year following the first sampling date. Macroinvertebrate community data has been analyzed using multimetric as well as multivariate techniques. No pattern of significant differences was seen in the biotic metrics analyzed. Multivariate analysis revealed that season had a significant effect at all sites at the genus level. Treatment had no significant effect on before and after communites at the genus level. A second objective was also analyzed to test for a significant positive relationship between the amount of detritus and biodiversity measures. It was found that 43 % of the variation in observations of the natural log of abundance could be explained by the mass of detritus in a sample using general linear model (r 2 = 0.43, p <0.001). Leading to the conclusion that biodiversity measures are positively related to the amount of detritus in the streams in this study.
Evaluation of Ergonomics Deficiencies in Nigerian Computer Workstations

The prevalence of Computer Workstations (CW) strain in developing countries such as Nigeria is becoming worrisome. This study is aimed at identifying ergonomic compliance in Nigeria computer workstations. To do this, structured questionnaires were employed to assess the health risk factors and checklist with oral interview was also used to measure physical dimensions of the CW under investigation. The major ergonomic deficiencies are includes: CW poor furniture, lighting and temperature control. The study reveals that 72%, 66%, 47%, 46% and 35% shown relative errors in terms of Chair height, chair back/arm rest, temperature, desk height and lighting respectively. The study also revealed that most of the Work Related Musculoskeletal Disorder (WRMD’s) complained injuries are: eye strain, shoulder pain, arm pain and back pain. Suggestions to reduce or eliminate these deficiencies were offered.
Inter-rater and intra-rater reliability of Kinovea software for measurement of shoulder range of motion

Background Goniometry is a tool used frequently for measuring and documenting range of motion (ROM) during a physical therapy examination. With modern innovations in technology, new methods other than the universal goniometer have been applied. Kinovea software is a recent video-based method that uses a virtual goniometer to obtain values for the ROM of joints. However, the software’s reliability in measuring shoulder joint ROM has not been studied. Purpose This study was conducted to investigate the inter-rater and intrarater reliability of Kinovea software for measuring shoulder joint ROM in healthy individuals. Materials and methods Shoulder joint ROM was measured in 52 healthy individuals (mean±SD age was 26.7±4.2 years) using Kinovea photographic measurements by three trained raters. Intrarater reliability was examined by a single rater within the same day. Shoulder flexion, abduction, and external and internal rotation ROM were measured with the patient in supine position. Results The inter-rater reliability ranged from an intraclass correlation coefficient value of 0.95 to 0.98, whereas the intrarater reliability ranged from an intraclass correlation coefficient value of 0.98 to 0.99. Conclusion This study showed highly reliable shoulder joint ROM measurements in healthy adults using the Kinovea software.
Assessment of the design–construction interface problems in the UAE

ABSTRACT Design–construction interface problems impede the successful delivery of construction projects within the specified time, cost and quality. The objective of this paper is to assess the design–construction interface problems in the United Arab Emirates (UAE) construction industry. Twenty-two problems were identified through literature review. A questionnaire survey was then developed and distributed to construction professionals. Thirty-nine responses were collected from consultants, contractors and construction professionals in government authorities. The weighted average of the responses was calculated. The results reveal that the most significant interface problems in the UAE include lack of coordination inside the design firm, lack of specialist construction manager, poorly written contract, lack of project management as individual professional service and time limitation in the design phase. Moreover, the paper analysed the responses according to company role. Most of these problems are caused by the lack of coordination and communication among the main contracting parties. Recommendations are made to enhance the coordination and management of construction projects that lead to reduction in the design–construction interface problems.
Global Colloquium in Recent Advancement and Effectual Researches in Engineering , Science and Technology ( RAEREST 2016 ) A simulation based study of flow velocities across cross flow turbine at different nozzle openings

The present work reports CFD based investigation of the effect of design parameters on the flow velocities of a cross flow turbine (CFT). Best described as an impulse type turbine with partial admission of air, cross flow turbines meet the demand for an efficient turbine to run at low head that is also easy to manufacture. The design of cross–flow turbine is unique due to the generation of power during two stages. This type of turbine is often used in small hydropower plants located in less–developed countries. The design parameters of CFT that can be varied to increase overall efficiency and power output of the turbine are water inlet angle, blade angle at inlet and outlet. In the present work the design parameters are varied for different nozzle openings and simulated using CFD. A full 3-D steady state flow simulation of the cross-flow turbine is performed including casing, runner and nozzle assembly. © 2015 The Authors. Published by Elsevier Ltd. Peer-review under responsibility of the organizing committee of RAEREST 2016.
Efficient Institutions: The Role of Exit and Voice ☆

Abstract Hirschman has repeatedly stated that Voice is better than Exit as citizens or clients response to dissatisfaction with the service provided by organizations of various nature. He also maintained that all too often Exit was preferred to Voice and the negative result would be that services of worse quality will be supplied in the system as a whole.Unfortunately, Hirschman never formalized his powerful categories and his fascinating ideas. The paper is an attempt to fill this gap; it also aims at showing how helpful Hirschaman’s approach can be in the endeavour to design efficient institutions.This paper provides a definition of efficiency convenient for our purposes and presents a model where both Exit and Voice can be necessary in order to achieve efficient results, given that the decline of organizations can have several different originating factors. Then it identifies the analytical conditions under which Exit is spontaneously chosen by citizens or clients despite being less efficient than Voice. The paper shows that the use of Exit when Voice would be more efficient is not as general as Hirschman seemed to imply but it can arise under well-specified circumstances. In its final part, the paper suggests how institutions should be designed in order to prevent such inefficient results.
Lung Ultrasound Performed by Primary Care Physicians for Clinically Suspected Community-Acquired Pneumonia: A Multicenter Prospective Study

PURPOSE We investigated whether lung ultrasound (US) performed in primary care is useful and feasible for diagnosing community-acquired pneumonia (CAP) compared with chest radiography, as most previous research has been conducted in hospital settings. METHODS We undertook a prospective observational cohort study of lung US performed in 12 primary care centers. Patients aged 5 years and older with symptoms suggesting CAP were examined with lung US (by 21 family physicians and 7 primary care pediatricians) and chest radiograph on the same day. We compared lung US findings with the radiologist’s chest radiograph report as the reference standard, given that the latter is the most common imaging test performed for suspected CAP in primary care. The physicians had varied previous US experience, but all received a 5-hour lung US training program. RESULTS The study included 82 patients. Compared with chest radiography, positive lung US findings (consolidation measuring >1 cm or a focal/asymmetrical B-lines pattern) showed a sensitivity of 87.8%, a specificity of 58.5%, a positive likelihood-ratio of 2.12, and a negative likelihood-ratio of 0.21. Findings were similar regardless of the physicians’ previous US training or experience. We propose a practical algorithm whereby patients having consolidation measuring greater than 1 cm or normal findings on lung US could skip chest radiography, whereas patients with a B-lines pattern without consolidation (given its low specificity) would need chest radiography to ensure appropriate management. Lung US was generally performed in 10 minutes or less. CONCLUSION Point-of-care lung US in primary care could be useful for investigating suspected CAP (avoiding chest radiography in most cases) and is likely feasible in daily practice, as short training programs appear sufficient and little time is needed to perform the scan.
The Provincial Spread and Scale of the Ontario eConsult Service: Evaluation of the First 2 Years

This paper reports on a multimethod cross-sectional study of the Ontario electronic consultation (eConsult) service. Utilization and closeout survey data from July 2018 through June 2020 were analyzed using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. Requesting clinicians submitted 60,474 eConsults, and monthly cases increased from 1,487 in July 2018 to 4,179 in June 2020. The median specialist response time was 1 day. An originally contemplated referral was avoided in 51% of cases. Ontario eConsult showed successful uptake across Ontario, demonstrating continued spread and scale, and offering a template for trailblazers looking to implement digital health innovations in their own jurisdictions.
Detecting Rainbow Trout Introgression in Bonneville Cutthroat Trout of the Bear River Basin Using Field-Based Phenotypic Characteristics

Abstract. Cutthroat trout Oncorhynchus clarkii × rainbow trout O. mykiss hybrids (hereafter hybrids) are difficult to visually distinguish from parental taxa, yet identifying phenotypic traits to separate hybrids from cutthroat trout is needed for conservation and management purposes. We compared phenotypic characteristics against genotype (using 34 species-diagnostic single nucleotide polymorphism loci) for 316 Bonneville cutthroat trout O. clarkii utah, rainbow trout and hybrids in Bear River tributaries. Our phenotypic classifications of fish were 91% accurate for Bonneville cutthroat trout but only 68% accurate for rainbow trout and hybrids combined. Classification errors based on phenotype were observed between parental taxa and hybrids but not between cutthroat trout and rainbow trout. The most useful phenotypic traits for distinguishing Bonneville cutthroat trout from hybrids were the absence of a white leading edge on the pelvic fin, the presence of fewer than 7 spots on the top of the head, and the presence of a prominent throat slash. The degree of hybridization in individual hybrids was associated with the number of spots on the top of their head. However, 16% of >F1 hybrids with a higher proportion of cutthroat trout ancestry and 6% of F1 hybrids exhibited all the phenotypic characteristics of cutthroat trout. The ability to visually detect admixture in hybrids was not related to fish length but was related to admixture level, with logistic regression model results predicting that, for individual hybrids when the proportion of alleles assigned to rainbow trout was >18% (95% CI, 11% to 26%), biologists were more than 50% likely to visually detect O. mykiss traits. While we encourage the use of genetic-based assessments for Bonneville cutthroat trout populations when feasible, our results suggest that phenotypic traits can assist in identifying hybridized populations and hybrid individuals, which will benefit the management and conservation of this species. However, our study included Bonneville cutthroat trout from only the Bear River basin, and further work is needed from the southern portion of the subspecies' range to support or refute our findings.