Miracle-dz/UniFAR-FTUs huggingface dataset:
Efficacy of a cardiac rehabilitation program in a municipal sports center compared to the hospital program: randomized controlled trial eCARCEX

Abstract Background: This study aimed to analyze the effects of an outpatient cardiac rehabilitation program in a municipal sports center on functional capacity and adherence to physical activity - among other variables - compared to an in-hospital program. Methods: Randomized clinical trial that included two parallel groups of acute coronary syndrome patients who performed a cardiac rehabilitation program that consisted of moderate physical exercise intervals along with learning healthy habits in a municipal sports center (EG) and in a tertiary hospital (CG) between September 2019 and June 2020. We collected the following data: compliance, anthropometrical, clinical, psychological variables, diet and tobacco habits, strength and functional capacity from ergospirometry. Results: Twenty-two patients completed the cardiac rehabilitation program (EG=12, CG=10). Significant improvement was observed for cholesterol, the sit-and-stand test, cardiac frequency in VT1 and VT2, and watts in VT1 in the CG, and for HDL-cholesterol, triglycerides, the sit-and-stand test, and frequency, and watts in VT1 in the EG. Better achievement was found in the CG for cardiac frequency in VT2 (11.17 vs 2.88 bpm) and in EG for HDL-cholesterol (11.0 vs 0.63 mg/dL). Conclusions: We are unable to determine the effectiveness of the out-of-hospital cardiac rehabilitation program due to a lack of power (high number of withdrawals caused by COVID-19 lockdown). However, the EG achieved higher HDL-cholesterol levels, while cardiac frequency in VT2 was higher in the CG.
What hindered the El Niño pattern in 2014?

At the beginning of 2014, an El Niño event was predicted to occur in the following winter. However, the El Niño that started to develop in 2014 was hindered in the boreal summer, and only the ocean reached a weak El Niño condition. This outcome was largely attributed to a suppressed ocean‐atmosphere interaction caused by anomalous easterly winds in the eastern equatorial Pacific. These winds were related to negative sea surface temperature anomalies (SSTAs) in the southeastern subtropical Pacific (SESP). The negative phase of the Interdecadal Pacific Oscillation (IPO) laid the foundation for the persistence of cooler SSTAs and enhanced trade winds in the SESP after the year 2000. As the recent IPO downward trend continued, the SSTAs in SESP reached an extremely low value in the boreal summer of 2014 and imposed a serious obstacle to the evolution of a warming event.
New drugs targeting calcitonin gene-related peptide for the management of migraines

ABSTRACT Introduction Significant advances in migraine research have contributed to the development of new drugs for the treatment of migraine. Monoclonal antibodies (mAbs) against Calcitonin Gene-Related Peptide (CGRP) or its receptor and CGRP receptor antagonists (gepants) have been associated with a good safety profile and resulted in an overall efficacy in reducing the number of monthly migraine days both in episodic and chronic forms of migraine. Areas covered The results from main investigation studies (phase 2 or 3) of CGRP-targeting drugs (both anti-CGRP mAbs and gepants) are reported in this expert-opinion review. Expert opinion The introduction of new drugs targeting CGRP is a significant breakthrough in the migraine field, and represents a new generation of therapeutic agents that are available to manage migraine. The evaluation of efficacy and safety in the long-term follow-up and the development of trials comparing the available drugs could improve the current knowledge. The economic sustainability of these drugs remains to be clarified, and a cost-cutting campaign should be promoted based on the high burden of migraine.
Effectiveness of an online management platform (Joint Cloud) versus standard process for patients undergoing total knee arthroplasty: study protocol for a prospective randomised controlled trial

Introduction Osteoarthritis (OA) is one of the main causes of mobility impairment in the elderly worldwide. Therefore, total knee arthroplasty (TKA) is often performed and is one of the most successful surgery and has resulted in substantial quality-of-life gains for people with end-stage arthritis. There is still room for improvement in the standard treatment process in the preoperative, intraoperative and postoperative period of TKA. Telerehabilitation has the potential to become a positive alternative to face-to-face rehabilitation nowadays. But it remains unclear how well telemedicine interventions cover the entire surgical pathway (preoperation, intraoperation, postoperation). This study aims to explore the effectiveness of Joint Cloud (JC, an online management platform) compared with existing standard process in regulating functional recovery, pain management, muscle strength changes and other health-related outcomes in patients undergoing total knee arthroplasty preoperation, intraoperation and postoperation. Methods and analysis A randomised controlled trial was designed to compare the online management platform (JC) with standard process (SP) in patients undergoing TKA. A total of 186 TKA patients will be randomly assigned to the intervention (n=93) or control (n=93) group. Patients in the intervention group will receive access to the ‘JC’ mini-program. This mini-program provides popular science information (eg, information about OA and TKA), functional exercise information and communication channels. Patients evaluate their condition and functional level through standardised digital questionnaires. The control group of patients will not accept any functions of this mini-program. The primary outcome is knee functional recovery, and the secondary outcomes are pain management, isometric knee extensor muscle strength, patient satisfaction and cost-benefit analysis. Assessments will be performed 1 month and 3 days before surgery (T0) and 1 month and 3 months after surgery. Data analysis will be performed according to the intent-to-treat (ITT) principle. Repeated measures of linear mixed models and parametric and non-parametric testing will be used for statistical analysis. Ethics and dissemination The study was reviewed and approved by the Tianjin Hospital Medical Ethics Review Committee on 10 February 2023 (2022YLS155). Test data are considered highly sensitive but are available upon request. The findings will be disseminated in peer-reviewed publications. Trial registration number ChiCTR2300068486.
Menopausal symptoms, exercise practices, and advice received in active women: a multi-country survey of strava app users

ABSTRACT The study aimed to identify the prevalence of symptoms, changes in exercise levels, and exercise advice received during the menopausal transition in a large multi-country sample. Using total population sampling, 2.5 percent of female Strava app users (n = 970) from 7 countries completed an online survey between 14 February 2019 and 11 March 2019. The survey discussed menopause status (perimenopausal or postmenopausal), menopausal symptoms, changes to exercise behaviors, and advice received concerning exercise during menopause. Frequencies, chi-square statistics, and linear regressions were used to analyze data. The most commonly reported menopausal symptoms were sexual (18–83 percent) and cognitive/psychological (77–78 percent). 41 percent of women reported no change in exercise behavior since menopause began (46 percent increased and 11 percent decreased behaviors). The majority (88 percent) of women did not receive advice regarding exercise during menopause. Women who received advice were more likely to report an increase in their exercise than those not receiving advice (60 percent vs 46 percent; X2 (df 2, n = 927) = 7.1, p = . 03). Exercise behaviors increased the longer it had been since the menopausal onset (X2 (df 8, n = 937) = 77.42, p < . 001). The results suggested high menopausal symptom prevalence in active women and a general lack of exercise advice. More women reported higher symptom prevalence and an increase in exercise participation, the longer it had been since menopause onset. Future research should determine whether these increased exercise behaviors are being used as a coping mechanism.
ISE/ISHNE expert consensus statement on the ECG diagnosis of left ventricular hypertrophy: The change of the paradigm

Abstract The ECG diagnosis of LVH is predominantly based on the QRS voltage criteria. The classical paradigm postulates that the increased left ventricular mass generates a stronger electrical field, increasing the leftward and posterior QRS forces, reflected in the augmented QRS amplitude. However, the low sensitivity of voltage criteria has been repeatedly documented. We discuss possible reasons for this shortcoming and proposal of a new paradigm. The theoretical background for voltage measured at the body surface is defined by the solid angle theorem, which relates the measured voltage to spatial and non‐spatial determinants. The spatial determinants are represented by the extent of the activation front and the distance of the recording electrodes. The non‐spatial determinants comprise electrical characteristics of the myocardium, which are comparatively neglected in the interpretation of the QRS patterns. Various clinical conditions are associated with LVH. These conditions produce considerable diversity of electrical properties alterations thereby modifying the resultant QRS patterns. The spectrum of QRS patterns observed in LVH patients is quite broad, including also left axis deviation, left anterior fascicular block, incomplete and complete left bundle branch blocks, Q waves, and fragmented QRS. Importantly, the QRS complex can be within normal limits. The new paradigm stresses the electrophysiological background in interpreting QRS changes, i.e., the effect of the non‐spatial determinants. This postulates that the role of ECG is not to estimate LV size in LVH, but to understand and decode the underlying electrical processes, which are crucial in relation to cardiovascular risk assessment.
Evaluation of risk factors for surgical site infections in osteoarthritis patients undergoing total knee arthroplasty

Abstract This research sought to delineate risk factors associated with surgical site infections (SSIs) post‐total knee arthroplasty (post‐TKA) in elderly osteoarthritis patients, aiming to enhance post‐surgical outcomes. A retrospective examination was conducted on a cohort of 650 elderly patients who underwent unilateral TKA between January 2018 and August 2022. Data procurement was from the hospital's Electronic Health Record, and a comprehensive statistical evaluation was performed using IBM SPSS Statistics version 24.0. Both univariate and multivariate techniques assessed a spectrum of risk determinants such as age, body mass index (BMI), coexisting medical conditions and surgical variables. The univariate examination spotlighted age, BMI, diabetes prevalence, chronic corticosteroid consumption and American Society of Anesthesiologists (ASA) physical status classification as notable predictors of SSIs. The multivariate logistic regression pinpointed age, BMI, history of smoking and diabetes diagnosis as salient risk attributors for post‐TKA infections. Concurrently, parameters like ASA classification, surgical duration and intraoperative haemorrhage further enriched the risk landscape. Geriatric patients undergoing TKA for knee osteoarthritis manifest a tangible infection susceptibility post‐surgery. Precision interventions concentrating on amendable risk components, including meticulous preoperative evaluations and strategic postoperative care, are imperative to attenuate SSI incidence, thereby amplifying surgical efficacy and optimizing patient recuperation trajectories.
Effect of rainfall intensity and slope gradient on soil erosion process on purple soil hill slopes

The runoff and sediment yield are strongly affected by the rainfall intensity and slope gradient.The laboratory experiment was conducted under simulated rainfalls to evaluate the effects of different rainfall intensities and slope gradients on sediment yield on the purple soil hill slope.The results show that the soil erosion processes and the changes of erosion type are closely related to rainfall intensity and slope gradient,and the sediment delivery rate is drastically increased and erratically fluctuate due to the occurrence and development of the rills during rainfall.The increase of rainfall intensity and slope gradient can reduce the critical runoff of occurrence of rills and accelerate the changes of rill morphology.For all the three rainfall intensities,both the total runoff and sediment yield increased with the rainfall intensity and slope gradient in the range of 5° ～ 25°,and reached the peak values at 25° slope,and then decreased at 30°slope.It indicated that there was a critical slope between 25° ～ 30°. The contribution ratio of rainfall intensity and slope gradient on the total sediment yield varied at different slope gradients,the slope gradient played a leading role under low rainfall intensity,while the rainfall intensity played a leading role under high rainfall intensity.
Source Identification and Apportionment of Particulate Matter and Aerosol Lead in Beijing

From September 2005 to September 2006,166 TSP samples were collected at a northern suburb (Changping District),downtown (city center),and a southern suburb (Fangshan District) in Beijing.Lead and 28 other elements were determined using ICP-AES and ICP-MS methods.Source identification and apportionment were conducted using the Positive Matrix Factor Analysis method.The results indicated that the TSP was mainly from soil dust,construction dust and coal combustion,and nonferrous minor sources were nonferrous industry and oil combustion.Major sources of aerosol lead in Beijing were coal combustion and nonferrous industries,which accounted for 19%-39% and 49%-62%,respectively,and the minor sources were soil dust and construction dust,which accounted for 2%-4% and 7%-8%,respectively.Annual average concentrations of aerosol lead were 102,142,179 ng/m3 for northern,downtown and southern sites in Beijing,respectively.Aerosol lead emitted from coal combustion uniformly distributed in the three sites and had similar ρ(Pb) ;however,aerosol lead emitted from nonferrous industry was significantly different in the three sites,with ρ(Pb) being higher in southern sites than in northern sites.This suggests that nonferrous industry mainly exists to the south of Beijing.There is substantial space for aerosol lead to decline in Beijing.The major target forlead pollution control and abatement should be non-ferrous metallurgy,especially lead oriented facilities,while the lead content in coal should not be overlooked in environmental management.
How does evidence-based medicine training affect medical students’ views on traditional, complementary, and alternative medicine and the conspiracy theories about COVID-19: a nationwide study

Abstract Aim: It was aimed to explore the relationship between evidence-based medicine (EBM) training and medical students’ views on traditional, complementary, and alternative medicine (TCAM) and their views on conspiracies about COVID-19. Background: Medical students constitute the future workforce of primary health care services. The relationship between EBM training and their views on conspiracies about COVID-19 is critical to explore for providing a better primary health care. The relationship EBM training and medical students’ views on TCAM is also important in this regard. Methods: This is a cross-sectional study. Turkish medical students were surveyed about EBM training, TCAM, and COVID-19 conspiracies. The electronic survey form consisted of five parts: Demographic characteristics, views and self-perceived knowledge about TCAM and the methods, views on the origin of SARS-COV-2, participation in EBM training, and views on TCAM training. A total of 49 medical schools provided response. Along with descriptive statistics, Chi-square test was utilized. Findings: Among 2577 participants, 24.0% of them believed SARS-COV-2 was artificially designed. The students who have participated in EBM training via both lecture and small group discussions have a less positive view on TCAM than both the students who have not participated in any EBM training (p < 0.05) and the students who participated in only-lectures (p < 0.05). There was a significant association between EBM training and whether believing COVID-19 (SARS-COV-2) has been designed purposefully by some people or it has emerged naturally χ 2 (1) = 17.21 p < 0.001. The odds of thinking COVID-19 emerged naturally was 1.85 times higher (95% CI: 1.38-2.47) if the students have participated in EBM training via both lectures and small group discussions than if they have not participated in any EBM training. EBM training affects medical students in terms of beliefs on COVID-19 conspiracies.
Diagnosing herbicide injury on garden and landscape plants

Accurately diagnosing plants that show herbicide injury symptoms is often difficult since, in many cases, other causes may be involved or it may be uncertain what herbicides were applied. Trained or experienced individuals may be able to tell if a specific herbicide injured a plant. These professionals often examine the plant symptoms and background information (including the type of herbicides used, application rates and timing, injury patterns, and the plant species affected) to confirm or discount the possibility of herbicide injury.
Exploring the Use of YouTube as a Pathology Learning Tool and Its Relationship With Pathology Scores Among Medical Students: Cross-Sectional Study

Background YouTube is considered one of the most popular sources of information among college students. Objective This study aimed to explore the use of YouTube as a pathology learning tool and its relationship with pathology scores among medical students at Jordanian public universities. Methods This cross-sectional, questionnaire-based study included second-year to sixth-year medical students from 6 schools of medicine in Jordan. The questionnaire was distributed among the students using social platforms over a period of 2 months extending from August 2022 to October 2022. The questionnaire included 6 attributes. The first section collected demographic data, and the second section investigated the general use of YouTube and recorded material. The remaining 4 sections targeted the participants who used YouTube to learn pathology including using YouTube for pathology-related content. Results As of October 2022, 699 students were enrolled in the study. More than 60% (422/699, 60.4%) of the participants were women, and approximately 50% (354/699, 50.6%) were second-year students. The results showed that 96.5% (675/699) of medical students in Jordan were using YouTube in general and 89.1% (623/699) were using it as a source of general information. YouTube use was associated with good and very good scores among the users. In addition, 82.3% (575/699) of medical students in Jordan used YouTube as a learning tool for pathology in particular. These students achieved high scores, with 428 of 699 (61.2%) students scoring above 70%. Most participants (484/699, 69.2%) reported that lectures on YouTube were more interesting than classic teaching and the lectures could enhance the quality of learning (533/699, 76.3%). Studying via YouTube videos was associated with higher odds (odds ratio [OR] 3.86, 95% CI 1.33-11.18) and lower odds (OR 0.27, 95% CI 0.09-0.8) of achieving higher scores in the central nervous system and peripheral nervous system courses, respectively. Watching pathology lectures on YouTube was related to a better chance of attaining higher scores (OR 1.96, 95% CI 1.08-3.57). Surprisingly, spending more time watching pathology videos on YouTube while studying for examinations corresponded with lower performance, with an OR of 0.46 (95% CI 0.26-0.82). Conclusions YouTube may play a role in enhancing pathology learning, and aiding in understanding, memorization, recalling information, and obtaining higher scores. Many medical students in Jordan have positive attitudes toward using YouTube as a supplementary pathology learning tool. Based on this, it is recommended that pathology instructors should explore the use of YouTube and other emerging educational tools as potential supplementary learning resources.
Determinants of implementing deprescribing for older adults in English care homes: a qualitative interview study

Objectives To explore the factors that may help or hinder deprescribing practice for older people within care homes. Design Qualitative semistructured interviews using framework analysis informed by the Consolidated Framework for Implementation Research (CFIR). Setting Participants were recruited from two care home provider organisations (a smaller independently owned organisation and a large organisation) in England. Participants A sample of 23 care home staff, 8 residents, 4 family members and 1 general practitioner were associated with 15 care homes. Results Participants discussed their experiences and perceptions of implementing deprescribing within care homes. Major themes of (1) deprescribing as a complex process and (2) internal and external contextual factors influencing deprescribing practice (such as beliefs, abilities and relationships) were interrelated and spanned several CFIR constructs and domains. The quality of local relationships with and support from healthcare professionals were considered more crucial factors than the type of care home management structure. Conclusions Several influencing social and contextual factors need to be considered for implementing deprescribing for older adults in care homes. Additional training, tools, support and opportunities need to be made available to care home staff, so they can feel confident and able to question or raise concerns about medicines with prescribers. Further work is warranted to design and adopt a deprescribing approach which addresses these determinants to ensure successful implementation.
Statistics of vertical vorticity, divergence, and strain in a developed submesoscale turbulence field

A detailed view of upper ocean vorticity, divergence, and strain statistics was obtained by a two‐vessel survey in the North Atlantic Mode Water region in winter 2012. Synchronous Acoustic Doppler Current Profiler sampling provided the first in situ estimates of the full velocity gradient tensor at O(1 km) scale without the usual mix of spatial and temporal aliasing. The observed vorticity distribution in the mixed layer was markedly asymmetric (skewness 2.5), with sparse strands of strong cyclonic vorticity embedded in a weak, predominantly anticyclonic background. Skewness of the vorticity distribution decreased linearly with depth, disappearing completely in the pycnocline. Statistics of divergence and strain rate generally followed the normal and χ distributions, respectively. These observations confirm a high‐resolution numerical model prediction for the structure of the active submesoscale turbulence field in this area.