Miracle-dz/UniFAR-FTUs huggingface dataset:
CD4+ cell count recovery after initiation of antiretroviral therapy in HIV-infected Ethiopian adults

Background CD4+ cell count recovery after effective antiretroviral therapy (ART) is an important determinant of both AIDS and non-AIDS morbidity and mortality. Data on CD4+ cell count recovery after initiation of ART are still limited in Sub-Saharan Africa. The aim of this study was to assess CD4+ cell count recovery among HIV-infected adults initiating ART in an Ethiopian setting. Methods A retrospective cohort study of HIV-infected adults initiating ART between September 2008 and June 2019 was carried out. CD4+ cell count recovery was defined as an increase in CD4+ cell count of >100 cells/mm3 from baseline or achievement of a CD4+ cell count >500 cells/mm3 at 12 months after ART initiation. Factors associated with CD4+ cell count recovery were evaluated using logistic regression analysis. Results Of the 566 patients included in this study, the median baseline CD4+ cell count was 264 cells/mm3 (IQR: 192–500). At 12 months after ART initiation, the median CD4+ cell count increased to 472 cells/mm3, and the proportion of patients with CD4+ cell count < 200 cells/mm3 declined from 28.3 to 15.0%. A total of 58.0% of patients had an increase in CD4+ cell count of >100 cells/mm3 from baseline and 48.6% achieved a CD4+ cell count >500 cells/mm3 at 12 months. Among patients with CD4+ cell counts < 200, 200–350 and >350 cells/mm3 at baseline, respectively, 30%, 43.9% and 61.7% achieved a CD4+ cell count >500 cells/mm3 at 12 months. In multivariable analysis, poor CD4+ cell count recovery (an increase of ≤100 cells/mm3 from baseline) was associated with older age, male sex, higher baseline CD4+ cell count and zidovudine-containing initial regimen. Factors associated with poor CD4+ cell count recovery to reach the level >500 cells/mm3 included older age, male sex and lower baseline CD4+ cell count. Conclusions CD4+ cell count failed to recover in a substantial proportion of adults initiating ART in this resource-limited setting. Older age, male sex and baseline CD4+ cell count are the dominant factors for poor CD4+ cell count recovery. Novel therapeutic approaches are needed focusing on high risk patients to maximize CD4+ cell count recovery and improve outcomes during therapy.
Impact of the COVID-19 pandemic on BMI: Its changes in relation to socio-demographic and physical activity patterns based on a short period

Background The COVID-19 pandemic is undoubtedly a major threat to the world. The preventive strategies designed to minimize the virus transmission by remaining at home, being isolated, and keeping social distance, which would substantially reform people’s lifestyle, physical activity, eating habits, etc. Consequently, those measures might create a disturbance in weight management and overweight. Therefore, how the COVID-19 pandemic has changed the physical activities of individuals and its impacts on the Body Mass Index (BMI) is explored herein. Methods An online-based cross-sectional study collected data from 338 Bangladeshi adults in November 2020. The questionnaire included socio-demographics, health-related variables, physical activity-related variables, and diet measurement. Inferential statistics (i.e., chi-square test, McNemar test) were used to measure the associations between BMI and studied variables with a consideration of two scenarios (‘before’ and ‘during’ the pandemic inception), where p<0.05 was considered statistically significant. Results Results showed that the prevalence of overweight was 30.5% ‘before’ the COVID-19 pandemic, which increased to 34.9% ‘during’ the pandemic; that means 4.4% of the participants significantly gained weight after the pandemic inception. There was no significant role of socio-demographic (e.g., gender, age, current residence, occupation) or physical activity-related factors (e.g., unavailability of outdoor space, not performing regular physical exercise, exercising with a partner) in changing the BMI status after the pandemic inception. However, following a proper diet plan during the COVID-19 pandemic was observed to decrease BMI status significantly. Conclusions The present study suggests that a minor portion of the participants reported increasing their overweight status after the pandemic inception, whereas having a proper diet plan during the pandemic can significantly decrease BMI status. Therefore, the importance of the appropriate diet plan should be considered while implementing any policies.
The psychology of vacationers’ hotel brand choice in a post-pandemic world

The present study investigated patrons’ intricate psychological process for hotel brand choice and preference. This research uncovered hotel selection attributes in shaping brand loyalty through customer experience, brand trust, brand attachment, age, and gender in the post-pandemic world. This paper categorized hotel selection attributes into that vacationers appreciate in the domestic tourism context. The findings indicated the significant effect of hotel selection attributes on customer experience, which in turn affect brand preference. Also, the moderating effect of age was identified in the relationship between hotel selection attributes and customer experience. This research is among the first to revisit hotel selection attributes for domestic tourism amid the pandemic and the way to cultivate the loyalty toward a hotel brand.
A literature review and analysis of the incident command system

Since the establishment of the incident command system (ICS), the debates of the effectiveness of using this system have never stopped. The majority of ICS debates can be related to the discussions of using a mechanistic system or an organic system in organisational theories. Consequently, I utilise the lens of organisational theory to review the ICS research and discussions over the past decades. After conducting an extensive literature review, I find three factors contributing to different evaluations of the ICS, they are: 1) disagreement on the nature of the ICS; 2) scale of disaster; 3) the implementation of the ICS. At the end of this research, I provide three future ICS research directions: 1) focusing on the nature of this system; 2) controlling the scale of disasters that are discussed; 3) further exploring how people really implement this system on the ground.
Predictive models and comparison of the selectivity of standard (T0) and turned mesh (T90) codends for three species in the

a b s t r a c t The main objective of this study was to compare and predict the size selective properties of 90◦ turned mesh codends (T90) with those of similar standard diamond mesh codends (T0) without other design changes. In particular, we wanted to investigate whether a T90 codend can be a simple way to improve size selectivity in the multi-species Mediterranean demersal trawl fisheries. Data were collected and
The effects of task demand on crew performance in simulated military land vehicles

New field vehicles, soon to be acquired by the Australian Army, will incorporate advanced in-vehicle information systems whose impact on operator workload and crewing requirements are yet to be examined. Three simulation studies were conducted as an exploration of the impact of existing and potential task demands on field vehicle crew performance. Army participants operated in driver/co-driver crews, performing in-vehicle tasks broadly analogous to those required in real-world field vehicles. Individual and crew performance was assessed under systematically manipulated task demands. Substantial declines in performance with time-on-task were found on simple repetitive vigilance and monitoring tasks, especially under the lowest task demand conditions. Increasing task demands or complexity generally helped mitigate those declines, but with a potential cost to overall performance. The results support effort regulation theory, with evidence of under-mobilization of engagement, effort and resources under monotonous, low demand conditions. Adaptive in-vehicle systems that monitor performance and allocate tasks to operators according to their functional state may prove beneficial. Study limitations and future studies in this area are discussed.
Measurement and modeling of residence time distribution of overflow ball mill in continuous closed circuit

Abstract Comparison between anticipated and measured mean residence time (MRT) along with analysis of the shape of residence time distribution (RTD) curves provides the most useful and valid information about mixing properties within a ball mill operating at industrial scale. In this work, the RTD measurements were carried out for a primary ball mill in closed circuit with hydrocyclones at two feed rates (i.e., 280 and 230 tons per hour (t/h)) by means of tracer technique. Also, perfect mixer, N-Mixer, and Weller models were studied to describe the RTD curves. It was found that the mixing condition inside the ball mill was very far from the perfect mixing circumstance. While, N-perfect mixer in series (N-Mixer model) showed better results compared to the large and small tanks in series (Weller model). According to the obtained results of the N-Mixer RTD model, when the ball mill throughput was enhanced from 230 t/h to 280 t/h, the MRT was decreased from 9.92 to 7.39 min, respectively. Moreover, relative variance of N-Mixer model diminished approximately 18% and particle cumulative passing from 75 μm of ball mill discharge increased 9%. Finally, it was concluded that operating in over-filled condition and poor mixing circumstance of slurry were the main reasons of low grinding efficiency.
Neuropsychological Effects of Chemotherapy

Background Findings from longitudinal studies can provide more conclusive evidence as to the impact of chemotherapy on cognitive functioning. Objectives This study aimed to (a) synthesize the evidence from longitudinal studies of the neuropsychological effects associated with chemotherapy in breast cancer patients, (b) identify associated factors, and (c) evaluate methodological issues. Methods Data were extracted from PubMed, EMBASE, CINAHL, PsycINFO, and the Cochrane Library. Inclusion criteria included the original study with the breast cancer sample, validated measure, and at least 1 baseline data point before and after chemotherapy began. Data accrued for sample characteristics, data-collection time points, statistical methods for longitudinal data analysis, outcome measures, and major findings (eg, longitudinal changes in cognitive function). Results We selected 42 articles for this review. The sample sizes ranged from 20 to 610, and most recruited were younger than 70 years. We found a trend across studies—statistically significant objective cognitive function deteriorations in severity and prevalence after initiating chemotherapy compared with a control group or relative to their baseline observations. A subsample, as high as 65%, experienced marked declines in cognitive function after initiating chemotherapy. The memory domain was most affected. The consistently associated factors were education, IQ, and regimen. Major methodological concerns were the measurement—the wide range of neuropsychological tests and a test’s unclear domains. Conclusion Chemotherapy affects objective cognitive function in some subsets. The highest-impact time point, mechanisms, and clinical significance of chemotherapy-associated cognitive impairment need additional evidence. Implication for Practice Clinicians must assess and manage cognitive impairment during and after chemotherapy.
Low voltage‐guided ablation of posterior wall improves 5‐year arrhythmia‐free survival in persistent atrial fibrillation

The posterior wall (PW) has been proposed as a standard target for ablation beyond pulmonary vein antral isolation (PVI) in patients with persistent atrial fibrillation (AF). However, studies have shown inconsistent outcomes with the addition of PW ablation. The presence or absence of low voltage on the PW may explain these inconsistencies. We evaluated whether PW ablation based on the presence or absence of low voltage improves long‐term arrhythmia‐free outcomes.
Is robotic gait training effective for individuals with cerebral palsy? A systematic review and meta-analysis of randomized controlled trials

Aim To determine if robotic gait training for individuals with cerebral palsy is more effective than the standard of care for improving function. Method PubMed, Embase, Scopus, and Cochrane databases were searched from 1980–January, 2022 for articles that investigated robotic gait training versus standard of care (i.e. physical therapy or standard gait training) for individuals with cerebral palsy. Articles were included if a randomized controlled trial design was used, and excluded if robotic gait training was combined with another neuromuscular intervention, such as functional electrical stimulation. A meta-analysis of outcomes measured in at least four studies was conducted. Results Eight citations met all criteria for full-text review and inclusion in the meta-analysis. A total of 188 individuals with cerebral palsy, ages four to 35, and Gross Motor Function Classification System levels I–IV were studied. Level of evidence ranged from 2b–1b. All studies utilized a tethered, assistive device for robotic gait training. The overall effect was not significantly different between the robotic gait training and control interventions for six minute walk test performance (95% CI: −0.17, 0.73; P = 0.22), free walking speed (95% CI: −0.18, 0.57; P = 0.30), or Gross Motor Function Measures D (Standing) (95% CI: −0.29, 0.39; P = 0.77) and E (Walking, Running and Jumping) (95% CI: −0.11, 0.57; P = 0.19). Conclusion Tethered robotic devices that provide assistive gait training for individuals with cerebral palsy do not provide a greater benefit for improving mobility than the standard of care.
Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for malignant gastric outlet obstruction: an international, multicenter, propensity score-matched comparison.

BACKGROUND Endoscopic duodenal stenting is the current standard treatment for malignant gastric outlet obstruction (GOO) in patients with limited life expectancy. However, duodenal stenting is prone to stent dysfunction. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel technique with potentially superior stent patency. We compared clinical success, safety, and stent dysfunction of EUS-GE and duodenal stenting in patients with malignant GOO using propensity score matching. METHODS This international, multicenter, retrospective study analyzed consecutive patients undergoing EUS-GE or duodenal stenting for GOO between 2015 and 2021 in three European centers. Primary outcomes were clinical success (GOO scoring system [GOOSS] ≥ 2) and stent dysfunction (GOOSS ≤ 1 after initial clinical success). A propensity score matching (1:1) analysis was performed using age, sex, underlying disease, disease stage, ascites, and peritoneal carcinomatosis as variables. RESULTS 214 patients underwent EUS-GE (n = 107) or duodenal stenting (n = 107). After propensity score matching, 176 patients were matched and compared. Technical success rates for EUS-GE and duodenal stenting were 94 % (95 %CI 89 %-99 %) vs. 98 % (95 %CI 95 %-100 %), respectively (P = 0.44). Clinical success rates were 91 % (95 %CI 85 %-97 %) vs. 75 % (95 %CI 66 %-84 %; P = 0.008). Stent dysfunction occurred in 1 % (95 %CI 0-4 %) vs. 26 % (95 %CI 15 %-37 %) of patients (P < 0.001). Adverse event rate was 10 % (95 %CI 4 %-17 %) vs. 21 % (95 %CI 12 %-29 %; P = 0.09). CONCLUSION EUS-GE had higher clinical success and lower stent dysfunction, with similar safety, compared with duodenal stenting, suggesting that EUS-GE may be preferred over duodenal stenting in patients with malignant GOO.
The Impact of Psychosexual Counseling in Women With Lichen Sclerosus: A Randomized Controlled Trial

Introduction Lichen sclerosus (LS) can affect sexuality and quality of life (QoL). Objective The aim of the study was to evaluate the impact of psychosexual counseling in women with LS. Materials and Methods One hundred fifty-eight women 18 years or older, newly diagnosed with LS, and referred to North Denmark Regional Hospital from January 2018 to November 2019 were included. The women were randomized in a 1:1 ratio to usual care or an intervention group receiving usual care and up to 8 individual consultations with a specialist in sexual counseling. Spouses or partners were encouraged to participate. The women filled out the questionnaires Female Sexual Function Index (FSFI), Dermatology Life Quality Index, and the WHO-5 Well-Being Index at baseline and after 6 months. Results The controls presented a mean score of 14.8 ± 8.7 and the intervention group presented a mean score of 12.8 ± 8.9 at FSFI. At follow-up, the controls had an FSFI score of 15.2 ± 9.2 and the intervention group revealed an FSFI score of 18.3 ± 9.5. Both groups experienced improved sexual functioning and for the intervention group the increase was significant (p < .001). At baseline, the Dermatology Life Quality Index mean score was 8.9 ± 5.6 for the control group and 9.3 ± 6.1 for the intervention group. At follow-up, the controls revealed a score of 8.6 ± 5.5 and the intervention group a score of 6.8 ± 5.8. The intervention group reached a significantly higher degree of QoL than the controls (p = .008). Conclusions Psychosexual counseling has a significant impact on sexual functioning and QoL in women with LS.
Post-exercise, passive heat acclimation with sauna or hot-water immersion provide comparable adaptations to performance in the heat in a military context

Abstract To mitigate the effects of heat during operations in hot environments, military personnel will likely benefit from heat acclimation (HA) conducted prior to deployment. Using post-exercise, passive heating, 25 participants completed a 5 d HA regime in sauna (70 °C, 18% RH) or hot-water immersion (HWI) (40 °C) for ≤40 min, preceded and followed by a heat stress test (1-h walking at 5 km.h−1 in 33 °C, 77% RH in military uniform (20 kg) before an incremental ramp to exhaustion). Fifteen completed both regimes in a randomised, cross-over manner. While performance did not significantly improve (+14%, [-1, 29], p = .079), beneficial adaptations were observed for mean exercising core temperature (-0.2 °C, [-0.2, −0.2], p <.001), skin temperature (-0.2 °C, [-0.2, −0.2], p = 035) and heart rate (-8 bpm, [-6, −10], p<.001) in both conditions. Post-exercise, passive HA of either modality may benefit military units operating in the heat. Practitioner summary: Strategies are required to prevent health and performance impairments during military operations upon arrival in hot environments. Using a randomised, cross-over design, participants completed five-day passive, post-exercise heat acclimation using sauna or hot-water immersion. Both regimes elicited beneficial albeit modest heat adaptations. Abbreviations: HA: heat acclimation; HST: heat stress test; HWI: hot-water immersion; RH: relative humidity
Etiologic Classification of Diffuse Parenchymal (Interstitial) Lung Diseases

Interstitial lung diseases (ILD) or diffuse parenchymal lung diseases (DPLD) comprise a large number of disorders. Disease definition and classification allow advanced and personalized judgements on clinical disease, risks for genetic or environmental transmissions, and precision medicine treatments. Registers collect specific rare entities and use ontologies for a precise description of complex phenotypes. Here we present a brief history of ILD classification systems from adult and pediatric pneumology. We center on an etiologic classification, with four main categories: lung-only (native parenchymal) disorders, systemic disease-related disorders, exposure-related disorders, and vascular disorders. Splitting diseases into molecularly defined entities is key for precision medicine and the identification of novel entities. Lumping diseases targeted by similar diagnostic or therapeutic principles is key for clinical practice and register work, as our experience with the European children’s ILD register (chILD-EU) demonstrates. The etiologic classification favored combines pediatric and adult lung diseases in a single system and considers genomics and other -omics as central steps towards the solution of “idiopathic” lung diseases. Future tasks focus on a systems’ medicine approach integrating all data and bringing precision medicine closer to the patients.
Habitual aerobic exercise in healthy postmenopausal women does not augment basal cardiac autonomic activity yet modulates autonomic-metabolic interactions

Abstract Objective: The aim of the present study was to examine the effects of habitual exercise training and metabolic health on basal cardiac autonomic function and cardiac autonomic recovery after exercise in healthy postmenopausal women (PMW). Methods: Habitually aerobically trained PMW (PMW-tr; 56 ± 1y; n = 11), and untrained PMW (PMW-un; 57 ± 1y; n = 13) and premenopausal women (PreM; ages 26 ± 1y; n = 14) were studied. Cardiac autonomic function, assessed using heart rate variability (HRV), was measured before and one hour after 45-minutes of moderate-intensity exercise (60% VO2peak). Fast Fourier frequency domain measures of high (HF; 0.15 Hz-0.4 Hz), low (LF; 0.04 Hz-0.15 Hz), very low (VLF; 0.01 Hz-0.04 Hz), and Total (VLF + LF + HF) HRV were assessed. Serum estradiol, insulin, and glucose were determined, and HOMA-IR, an index of insulin resistance, was calculated. Results: In PMW groups, body composition and serum markers did not differ (P > 0.05). Pre-exercise, heart rate was lower (P < 0.05) in PMW-tr than PMW-un, yet HRV did not differ (P > 0.05). In PMW-tr only, HF was inversely associated (P < 0.05) with insulin (r = -0.738) and HOMA-IR (r = -0.758). In PreM, HRV was higher than PMW (P < 0.05) and was positively correlated with estradiol (P < 0.05). Postexercise, HRV was decreased within all groups (P < 0.05) yet remained higher in PreM (P < 0.05), and similar (P > 0.05) between PMW. Conclusions: Basal and postexercise HRV does not differ between habitually aerobically trained and untrained PMW. However, greater insulin sensitivity was associated with higher cardiac parasympathetic tone in trained PMW only. Exercise training may favorably modulate cardiac autonomic-metabolic interactions in PMW.
The Impact of Public, Private, and Out-of-Pocket Health Expenditures on Under-Five Mortality in Malaysia

Health financing in Malaysia is intensely subsidised by public funding and is increasingly sourced by household out-of-pocket financing, yet the under-five mortality rate has been gradually increasing in the last decade. In this context, this study aims to investigate the relationship between public, private, and out-of-pocket health expenditures and the under-five mortality rate in Malaysia using the autoregressive distributed lag (ARDL) estimation technique, whereby critical test values are recalculated using the response surface method for a time-series data of 22 years. The findings reveal that out-of-pocket health expenditure deteriorates the under-five mortality rate in Malaysia, while public and private health expenditures are statistically insignificant. Therefore, an effective health financing safety net may be an option to ensure an imperative child health outcome.