Miracle-dz/UniFAR-FTUs huggingface dataset:
Limited English proficiency inhibits auditory verbal learning in cognitively healthy young adults – exploring culturally responsive diagnostic and educational safeguards

Abstract This study was designed to examine the effect of limited English proficiency (LEP) on the Hopkins Verbal Learning Test-Revised (HVLT-R). The HVLT-R was administered to 28 undergraduate student volunteers. Half were native speakers of English (NSE), half had LEP. The LEP sample performed significantly below NSE on individual acquisition trials and delayed free recall (large effects). In addition, participants with LEP scored 1.5–2 SDs below the normative mean. There was no difference in performance during recognition testing. LEP status was associated with a clinically significant deficit on the HVLT-R in a sample of cognitively healthy university students. Results suggest that low scores on auditory verbal learning tests in individuals with LEP should not be automatically interpreted as evidence of memory impairment or learning disability. LEP should be considered as grounds for academic accommodations. The generalizability of the findings is constrained by the small sample size.
How spaceflight challenges human cardiovascular health.

The harsh environmental conditions in space, particularly weightlessness and radiation exposure, can negatively affect cardiovascular function and structure. In the future, preventive cardiology will be crucial in enabling safe space travel. Indeed, future space missions destined to the Moon and from there to Mars will create new challenges to cardiovascular health while limiting medical management. Moreover, commercial spaceflight evolves rapidly such that older persons with cardiovascular risk factors will be exposed to space conditions. This review provides an overview on studies conducted in space and in terrestrial models, particularly head-down bedrest studies. These studies showed that weightlessness elicits a fluid shift towards the head, which likely predisposes to the spaceflight-associated neuro-ocular syndrome, neck vein thrombosis, and orthostatic intolerance after return to Earth. Moreover, cardiovascular unloading produces cardiopulmonary deconditioning which may be associated with cardiac atrophy. In addition to limiting physical performance, the mechanism further worsens orthostatic tolerance after return to Earth. Finally, space conditions may directly affect vascular health, however, the clinical relevance of these findings in terms of morbidity and mortality is unknown. Targeted preventive measures, which are referred to as countermeasures in aerospace medicine, and technologies to identify vascular risks early on will be required to maintain cardiovascular performance and health during future space missions.
Sleep Characteristics, Mood, Somatic Symptoms, and Self-Care Among People With Heart Failure and Insomnia

Background Almost 50% of people with heart failure (HF) experience chronic insomnia and must perform self-care to manage their day-to-day healthcare needs. Understanding multifactorial influences on self-care, including demographic, clinical, and sleep characteristics, and mood and somatic symptoms will help identify people at highest risk for poor self-care. However, past research focused only on the associations of single symptoms and self-care. Multivariate approaches are needed to account for the synergistic associations of self-care with sleep, mood, and somatic symptoms among people with HF. Objectives The aims of the study were to (a) evaluate the levels of self-care maintenance and self-care confidence among people with stable HF and chronic insomnia; (b) identify the clinical and demographic correlates of self-care maintenance and confidence among people with stable HF and chronic insomnia; and (c) identify the associations between sleep characteristics, mood and somatic symptoms, and self-care maintenance and confidence among people with stable HF and chronic insomnia. Methods We utilized a cross-sectional design with 195 adult participants who had chronic HF and insomnia. We assessed for symptoms of anxiety; depression; dyspnea; fatigue; stress; insomnia severity; and sleep disturbance, impairment, and quality. Self-care was measured using the Self-Care for Heart Failure Index v6.2. We used generalized linear models to test the associations between the demographic and clinical factors and self-care maintenance and confidence; exploratory and confirmatory factor analysis to identify the factor structure underlying the symptoms; and structural equation modeling to test the combined associations of the demographic and clinical factors and latent factors with self-care maintenance and confidence. Results Self-care maintenance, confidence, and management were inadequate in most participants. We identified three latent factors among the nine symptoms: “sleep characteristics,” “mood,” and “somatic symptoms. ” In the structural equation model, “sleep characteristics,” White race, and having a left ventricular ejection fraction of <45 were associated with self-care maintenance. Age was negatively associated with self-care confidence. Discussion Poor sleep characteristics negatively influence the ability of people with HF and insomnia to perform self-care behaviors. Knowledge of the associations among age, left ventricular ejection fraction, and race with self-care will help clinicians and future researchers identify those at risk for poor self-care.
The impact of B‐cell‐directed therapy on SARS‐CoV‐2 vaccine efficacy in chronic lymphocytic leukaemia

Prior reports evaluating SARS‐CoV‐2 vaccine efficacy in chronic lymphocytic leukaemia (CLL) used semiquantitative measurements of anti‐S to evaluate immunity; however, neutralization assays were used to assess functional immunity in the trials leading to vaccine approval. Here, we identified decreased rates of seroconversion in vaccinated CLL patients and lower anti‐S levels compared to healthy controls. Notably, we demonstrated similar results with the Roche anti‐S assay and neutralization activity. Durable responses were seen at six months; augmentation with boosters was possible in responding patients. Absence of normal B cells, frequently seen in patients receiving Bruton tyrosine kinase and B‐cell lymphoma 2 inhibitors, was a strong predictor of lack of seroconversion.
Assessment of Refractive Outcome of Photo Refractive Keratectomy in Myopia and Myopic Astigmatism.

OBJECTIVES To determine the refractive outcomes of wavefront optimized photo refractive keratectomy (PRK) in patients having myopia and myopic astigmatism in terms of efficacy, safety, accuracy, stability and predictability of the procedure. STUDY DESIGN Quasi-experimental study. PLACE AND DURATION OF STUDY Refractive Surgical Unit, Armed Forces Institute of Ophthalmology, National University of Medical Sciences, Rawalpindi, Pakistan, from October 2013 to August 2018. METHODOLOGY Patients having myopia and myopic astigmatism, consented to be a part of the study, underwent meticulous screening consisting of detailed medical history, ocular examination and investigations. Each case was compiled and evaluated. Those who satisfied the criteria for refractive surgery were subjected to PRK procedure. Postoperative follow-up was carried out and parameters were recorded at designated intervals of 1 week, 1, 3, 6 and 12 months. RESULTS This study included 208 eyes of 106 patients with mean age of 25.33 + 5.196 years. At the end of one year, 97% (202 out of 208) eyes had uncorrected distance visual acuity (UDVA) better than 20/25 with efficacy index of 1.009 ± 0.132 and safety index of 1.019 ± 0.126. None of the eyes lost two or more lines. In this study, 207 out of 208 eyes remained within + 0.50 diopter (D) of intended spherical equivalent (SEQ). Results showed 100% accuracy of procedure since all the study patients achieved SEQ within + 1D. CONCLUSION PRK is an effective, predictable, and safe treatment procedure for correcting myopia and myopic astigmatism. Key Words: Photorefractive keratectomy, Myopia, Refractive surgery, Myopic astigmatism, Uncorrected distance visual acuity.
Simplified Magnetic Resonance Index of Activity Is Useful for Terminal Ileal but not Colonic Disease in Pediatric Crohn Disease

ABSTRACT Background: Ileocolonoscopy (IC) detects mucosal inflammation and magnetic resonance enterography (MRE) detects transmural inflammation in Crohn disease (CD). We aimed to evaluate the relationship between the simplified magnetic resonance index of activity (MARIAs) and measures of inflammation by IC in children with newly diagnosed CD. Methods: Retrospective review of 140 patients 6–18 years of age with CD who had baseline IC and MRE within 5 weeks of diagnosis. MARIAs was calculated for each intestinal segment (terminal ileum [TI], ascending colon, transverse colon, descending colon, sigmoid colon, rectum), defined as (1 × thickness > 3 mm) + (1 × edema) + (1 × fat stranding) + (2 × ulcers). Sensitivity and specificity were derived using receiver operating characteristic (ROC) curves to compare MARIAs to IC findings. Results: Using IC as the reference standard, the cutoff MARIAs ≥1 identified TI segments with active inflammation with 84% sensitivity, 73% specificity, 85% positive predictive value (PPV), 70% negative predictive value (NPV), and area under the curve (AUC) 0.782 (95% confidence interval [CI] 0.689–0.876). The cutoff MARIAs ≥2 identified TI segments with severe lesions with 87% sensitivity, 76% specificity, 87% PPV, 76% NPV, and AUC 0.814 (95% CI 0.712–0.916). There was poor sensitivity for all colonic segments. Conclusion: The MARIAs is feasible and accurate in reflecting disease activity in the TI, but not in the colon, in children with newly diagnosed CD. Although the MARIAs may be useful for monitoring TI disease activity over time, full assessment continues to require both IC and MRE.
Anti-Ro52 antibodies are associated with the prognosis of adult idiopathic inflammatory myopathy-associated interstitial lung disease.

OBJECTIVES In the present study, we aimed to assess the prevalence and clinical significance of anti-Ro52 antibodies in a cohort of patients with idiopathic inflammatory myopathy-associated interstitial lung disease (IIM-ILD) with different myositis-specific autoantibodies (MSAs). METHODS A cohort of 267 IIM-ILD patients, including 62 patients with polymyositis (PM), 126 patients with dermatomyositis (DM), and 79 patients with clinically amyopathic dermatomyositis (CADM), were retrospectively analysed in this study. Clinical and laboratory findings, pulmonary function tests (PFTs), HRCT patterns and treatment information were compared between patients with and without anti-Ro52 antibodies. The association between prognosis and anti-Ro52 antibodies was also evaluated based on different MSA subgroups. RESULTS Anti-Ro52 antibodies were more frequent in patients with anti-MDA5 (62.1%, p< 0.01) and anti-Jo1 (64.9%, p< 0.01) antibodies than in those with other MSAs. The proportion of patients with anti-Jo1 antibodies was higher in the anti-Ro52 antibody-positive group than in the anti-Ro52 antibody-negative group. Patients with anti-Ro52 antibodies were more likely to exhibit the Gottron sign than the anti-Ro52 antibody-negative group (p< 0.001). Furthermore, it was a predictive factor for rapid progression interstitial lung disease (RP-ILD) (p= 0.001) and was also associated with a higher mortality rate (log-rank test, p< 0.01). Furthermore, RP-ILD was more frequently exhibited in anti-MDA5- and anti-Ro52-positive patients. Moreover, anti-Ro52 antibody positivity was closely associated with a higher mortality rate in anti-MDA5-ILD patients (log-rank test, p< 0.05). CONCLUSIONS Anti-Ro52 antibodies were highly prevalent in patients with anti-MDA5 and anti-Jo1 antibodies. Within all patients with IIM-ILD, those with anti-Ro52 autoantibodies had a higher frequency of RP-ILD and a poorer prognosis, especially in the anti-MDA5 antibody subgroup.
Knowledge of pregnancy complications and utilization of antenatal care services in Rwanda.

BACKGROUND While Rwanda's progress towards achieving the maternal health care targets of the Sustainable Development Goals is impressive, evidence of women's limited utilization of antenatal care (ANC) services in the context of an improved health care system provides an opportunity for exploring other essential but less highlighted factors that may shape ANC service utilization. In this study, we examined the association between women's knowledge of pregnancy complications and the utilization of maternal health services. METHODS We employed logistic regression analysis using the 2015 Rwanda Demographic and Health Survey data. Our analytical sample consisted of women (n = 5883) in their reproductive ages (15-49 years). Three maternal health care indicators, namely, timing of first ANC visit, number of ANC visits, and place of delivery, were explored. We controlled for the effects of socioeconomic and demographic characteristics, including marital status, place of residence and age. RESULTS The results show that women with no knowledge of pregnancy complications were less likely to utilize ANC services within the first trimester (odds ratio [OR] = 0.76, p < 0.01), achieve the WHO recommended minimum of eight visits (OR = 0.66, p < 0.01), and deliver at a health facility (OR = 0.77, p < 0.10). CONCLUSION Given these findings, we recommend restructuring existing maternal health care programs to include rigorous maternal health education.
The Effect of Business Strategy on R&D Expenditure and Firm Performance – Evidence from Taiwan

Abstract This paper aims to investigate the effect of generic strategy on R&D spending and the impact of R&D spending on firms’ performance conditional on their strategic position. This empirical study uses accounting data of 597 listed Taiwanese firms in the manufacturing industry from 2013 to 2017. The data was obtained from Taiwan Economic Journal (TEJ) database. The results indicate that firms that adopt a differentiation strategy have more R&D spending than companies with a cost leadership strategy. Furthermore, the authors find that R&D spending positively affects firms’ performance if they pursue a differentiation strategy. Meanwhile, the relationship between R&D spending and firm performance forms an inverted U-shape for those who adopt a cost leadership strategy. First, for firms adopting the differentiation strategy, the investment in R&D is critical because the more investment on R&D these firms spend, the better performance they will gain. Second, for firms with a cost-leadership strategy, R&D spending is also essential to improve efficiency. However, they should allocate the budgets wisely and reasonably, as controlling cost is the main focus of this strategy to keep their competitive advantages. This study examines the relationship between R&D spending, business strategy, and firm performance in Taiwan. Further, the study suggests that manufacturing firms in Taiwan allocate their resources wisely and efficiently according to their system.
Performance Evaluation of the Fruit and Vegetable Subsectors in the Azerbaijani Economy: a Combinatorial Analysis Using Regression and Principal Component Analysis

Abstract Azerbaijan has an oil-led economy, which according to the well-known resource curse and Dutch disease hypotheses decreases the role of non-oil tradable sectors. Nevertheless, the government has actively fostered the growth of non-oil tradable sectors as the export orientation of Azerbaijan is being leveraged by the recently adopted economic policies. However, performance evaluations at the subsectoral level remain rare. The present paper evaluates the performance of the fruit and vegetable subsectors in Azerbaijan from 1995 to 2020 based on multiple key indicators, such as production, profitability, and productivity via principle component analysis (PCA). The purpose of the study was to provide a comparison of two key subsectors in Azerbaijan that are strong candidates for non-oil tradable exports. The results revealed that the vegetable subsector outperformed the fruit subsector in terms of production and profitability from 1999 to 2014; however, it experienced a sharp decline from 2014 to 2015 (the period of the rapid commodity price downturns), which gives rise to the question of whether the extractive industry negatively affected the subsector. Compared to the vegetable subsector, production and profitability in the fruit subsector demonstrated a more stable upward trend. In addition, labor input in both sub-sectors decreased over time, indicating efficiency gains via new technology transfers and productivity enhancements. Ordinary Least Squares (OLS) results demonstrated a strong and statistically significant negative relationship between the performance of the vegetable subsector with the oil revenue boom period (2008–2015).
Sexual coercion in a natural mandrill population

Increasing evidence indicates that sexual coercion is widespread. While some coercive strategies are conspicuous, such as forced copulation or sexual harassment, less is known about the ecology and evolution of intimidation, where repeated male aggression promotes future rather than immediate mating success with targeted females. Although known in humans, intimidation was recently reported in chimpanzees (Pan troglodytes) and chacma baboons (Papio ursinus), where males are regularly violent against females. Here, we investigate the nature of male coercive strategies in wild mandrills (Mandrillus sphinx), a primate living in large polygynandrous groups where severe male aggression towards females is rare and females can form coalitions against males. Yet, we found support for all three predictions of the sexual coercion hypothesis, namely that male aggression (1) specifically targets sexually receptive females, (2) inflicts costs to these females, and (3) increases male mating success in the long-term. These results hold true when considering only non-physical threats, or only severe aggression. Finally, we show that high-ranking females are most targeted by males, probably because of their higher reproductive performances, while high-ranking males are most coercive. These results indicate that sexual intimidation is widespread in sexually dimorphic and group-living mammals, and that males and females vary in their propensities to use, and to be exposed to sexual coercion, respectively.
Association between Smoking and Overall and Specific Mortality in Patients with Bladder Cancer: A Population-based Study

BACKGROUND: The role of smoking in the prognosis of bladder cancer may significantly impact clinical management. It is also a considerable burden to Taiwan’s economy and health of its citizens. OBJECTIVE: To search Taiwan’s National Health Insurance Research Database to determine whether smoking affected overall and cancer-specific mortality of patients with bladder cancer. METHODS: We collected data on basic information, tumor stage, and comorbidities. Each smoking case was propensity score-matched by age, sex, and diagnosis year to one control individual among bladder cancer patients. The study comprised a never-smoke and an ever-smoke group, with each group including 4,728 patients after matching. We evaluated the association between smoking and mortalities in patients with bladder cancer. Cox proportional regression modeling was used to estimate hazard ratios (HRs) of overall and cancer-specific mortality rates. Stratified analysis was also performed to estimate risk ratios of overall and cancer-specific mortalities in bladder cancer patients with and without a history of smoking history among different subgroups. RESULTS: The overall and specific mortality ratio of patients who were ever smokers were 1.15-fold and 1.16-fold, respectively, compared with those of never smokers (overall: 95% confidence interval [CI], 1.06–1.26, P = 0.0014; specific: 95% CI, 1.03–1. 03, P = 0.0176). Patients with bladder cancer who smoked and had significantly higher overall and specific mortality rates were those with Charlson Comorbidity Index (CCI)≥3 (overall: P = 0.0119; specific: P = 0.0092), diabetes mellitus (DM; overall: P = 0.0046; specific: P = 0.0419), and non-muscle-invasive bladder cancer (NMIBC; overall: P = 0.0038; specific: P = 0.0014). CONCLUSIONS: Overall and specific mortality rates were significantly higher in the ever-smoke group than in the never-smoke group. The ever-smoke group with male sex, CCI≥3, DM, and NMIBC had increased risks for overall and specific mortality.
Simulación de formación educativa y profesional de estudiantes

El estudio aborda los problemas de mejorar la eficiencia del proceso educativo mediante la simulación de la capacidad para trabajar de forma independiente. Es la capacidad para trabajar de forma independiente lo que se destaca como indicador de la eficacia de la simulación. Para el estudio, se utilizaron encuestas y cuestionarios, métodos de recopilación y procesamiento de información a distancia, métodos de diagnóstico de la motivación de aprendizaje de los estudiantes, motivación de la actividad profesional, una técnica de estudio de motivación para aprender en instituciones de educación superior, un método de distribución normal estándar. La evaluación del criterio motivacional mostró que solo el 7% de los estudiantes alcanzó el nivel creativo. Más del 80% de los encuestados cree que las actividades de investigación en las IES son una parte integral de la formación profesional. El 41% de los encuestados demostró el nivel óptimo de competencias. Se ha encontrado que los estudiantes tienen la oportunidad de resolver una serie de problemas académicos en el curso de la simulación. Como resultado, los estudiantes adquieren las competencias educativas necesarias. Se reveló que la introducción de tecnologías para la simulación de la formación educativa y profesional tiene consecuencias positivas para la preparación de los estudiantes para una mayor actividad profesional independiente.
Sleep Duration, Number of Awakenings and Arterial Stiffness in Industrial Shift Workers: A Five-Week Follow-Up Study

Shift work may increase the risk for hypertension and arterial stiffness, potentially a consequence of disturbed sleep. The aim of this study was to investigate possible correlations between sleep length and spontaneous awakenings with selected cardiovascular risk factors in shift workers at an industrial plant. We examined 19 shift workers by means of blood pressure and arterial stiffness, measured as pulse wave velocity (PWV), prior to and after a 5-week shift period. Sleep patterns were monitored on a daily basis with the assistance of a smartphone-based sleep diary (the entire test period) and by actigraphy (limited to 2 weeks). The number of awakenings and total sleep time were calculated. Shorter sleep duration was associated with higher blood pressure and partly with higher PWV, indicating an increased risk of cardiovascular disease (CVD) with reduced sleep duration. Unexpectedly, a lower number of awakenings was associated with an increase in blood pressure, indicating a reduced risk of CVD. No other significant associations were determined. The results from the present study among shift workers in Norway could support the hypothesis that short sleep duration is associated with elevated blood pressure and arterial stiffness.