Miracle-dz/UniFAR-FTUs huggingface dataset:
The evaluation of anaemia in an older primary care population: retrospective population-based study

Background Anaemia is common in older people and the identification of potentially reversible haematinic deficiencies relies on appropriate investigation, often undertaken in primary care. Aim To determine the laboratory prevalence of anaemia, the types of anaemia observed, and the biochemical and haematological investigations undertaken to characterise any associated haematinic abnormality in older primary care patients. Design & setting A retrospective primary care based study of patients aged >65 years undergoing a full blood count in Oxfordshire, UK between 1 January 2012 and 31 December 2013. Method Consecutive patients aged >65 years with a full blood count were identified retrospectively from a laboratory database. Patient demographics, number of blood tests and additional laboratory investigations requested were recorded. World Health Organisation (WHO) criteria were used to define anaemia. Results In total 151 473 full blood counts from 53 890 participants were included: 29.6% of patients were anaemic. The majority had a normocytic anaemia (82.4%) and 46.0% of participants with anaemia had no additional investigations performed. The mean haemoglobin was lower in the anaemic group that underwent further investigation than those who did not (Hb 10.68 g/dl versus 11.24 g/dl, P<0.05): 33.2 % of patients with a microcytic anaemia (mean cell volume <80) did not have any markers of iron status measured. Conclusion A large proportion of older adults in primary care with a recent blood test are anaemic, the majority with a normocytic anaemia, with evidence of inadequate investigation. Those with lower haemoglobin are more likely to be further investigated. Further work is needed to understand the approach to anaemia in older adults in primary care.
THE EFFECT OF CONTROLS ON THE PREVENTION OF ONLINE EXAMINATION FRAUD

The purpose of this study is to identify the effect of controls and heavy punishment on the prevention of online examination fraud for professional students at one of the universities in Malaysia. The study has listed five potential key factors as follows: (1) identity verification, (2) monitoring, (3) toilet visit procedures, (4) punishment
Use of concept maps in university education in the field of control technology

In the context of this study 𝑛𝑛 = 16 students in the diploma program in mechanical engineering created concept maps on the content of the lecture previously given in the module "Control of Production Machines and Systems". The concept maps were then evaluated according to three criteria described in more detail here. As a basis for the evaluation of the individual concept maps, they were compared with a reference map prepared by three experts in the field of mech-atronics within the scope of this study. Immediately after the creation of the maps, the students answered a questionnaire that included demographic data as well as a self-assessment survey on concept mapping. The 10 items of this sheet are assigned to the subject characteristics inter-estingness, usefulness and manageability. The subject characteristics and evaluation criteria were examined for initial dependencies. The tendency showed that the students generally evaluate the method of concept mapping as positive, despite first-time application and shortened introduction.
Evolution of the Magnetic Field in High- and Low-β Disks with Initially Toroidal Fields

We present the results from a pair of high-resolution, long-timescale (∼105 GM/c 3), global, three-dimensional magnetohydrodynamical accretion disk simulations with differing initial magnetic plasma β in order to study the effects of the initial toroidal field strength on the production of a large-scale poloidal field. We initialize our disks in approximate equilibrium with purely toroidal magnetic fields of strength β 0 = 5 and 200. We also perform a limited resolution study. We find that simulations of differing field strengths diverge early in their evolution and remain distinct over the time studied, indicating that the initial magnetic conditions leave a persistent imprint in our simulations. Neither simulation enters the magnetically arrested disk regime. Both simulations are able to produce poloidal fields from initially toroidal fields, with the β 0 = 5 simulation evolving clear signs of a large-scale poloidal field. We make a cautionary note that computational artifacts in the form of large-scale vortices may be introduced in the combination of initially weak field and disk-internal mesh refinement boundaries, as evidenced by the production of an m = 1 mode overdensity in the weak field simulation. Our results demonstrate that the initial toroidal field strength plays a vital role in the simulated disk evolution for the models studied.
"That's part of the culture:" A peer-to-peer study of reporting student mistreatment

Introduction: Forty percent of graduating medical students report experiencing student mistreatment; however, most cases go unreported. Methods: Peer-to-peer, semi-structured interviews with current medical students were conducted to understand medical students' experiences with mistreatment and reporting. These interviews were inductively coded, and themes were identified to elucidate reasons students do and do not report mistreatment. Results: Twenty-one students were interviewed who described a total of 34 mistreatment incidents. Four main groups of factors that students consider when deciding to report mistreatment were identified: personal, situational, structural, and climate. Personal factors were intrinsically tied to the participant, including their feelings or concerns about mistreatment. Situational factors related to the act of mistreatment, such as who the perpetrator was or the actions of bystanders. Structural factors included elements of the reporting system. Climate factors were concerns related to how the institution viewed mistreatment and the student's place in medical education. Discussion: This peer-to-peer study revealed four main groups of factors, all of which are influenced by the culture of the institution. Participants were impacted by the inactions of witnesses and their personal sense of justice. An approach to facilitating reporting of student mistreatment must be grounded in improving the culture of medical education.
Outcomes following major thoracoabdominal cancer resection in adults with congenital heart disease

Background While advances in medical and surgical management have allowed >97% of congenital heart disease (CHD) patients to reach adulthood, a growing number are presenting with non-cardiovascular malignancies. Indeed, adults with CHD are reported to face a 20% increase in cancer risk, relative to others, and cancer has become the fourth leading cause of death among this population. Surgical resection remains a mainstay in management of thoracoabdominal cancers. However, outcomes following cancer resection among these patients have not been well established. Thus, we sought to characterize clinical and financial outcomes following major cancer resections among adult CHD patients. Methods The 2012–2020 National Inpatient Sample was queried for all adults (CHD or non-CHD) undergoing lobectomy, esophagectomy, gastrectomy, pancreatectomy, hepatectomy, or colectomy for cancer. To adjust for intergroup differences in baseline characteristics, entropy balancing was applied to generate balanced patient groups. Multivariable models were constructed to assess outcomes of interest. Results Of 905,830 patients undergoing cancer resection, 1,480 (0.2%) had concomitant CHD. The overall prevalence of such patients increased from <0.1% in 2012 to 0.3% in 2012 (P for trend<0.001). Following risk adjustment, CHD was linked with greater in-hospital mortality (AOR 2.00, 95%CI 1.06–3.76), as well as a notable increase in odds of stroke (AOR 8.94, 95%CI 4.54–17.60), but no statistically significant difference in cardiac (AOR 1.33, 95%CI 0.69–2.59) or renal complications (AOR 1.35, 95%CI 0.92–1.97). Further, CHD was associated with a +2.39 day incremental increase in duration of hospitalization (95%CI +1.04–3.74) and a +$11,760 per-patient increase in hospitalization expenditures (95%CI +$4,160–19,360). Conclusions While a growing number of patients with CHD are undergoing cancer resection, they demonstrate inferior clinical and financial outcomes, relative to others. Novel screening, risk stratification, and perioperative management guidelines are needed for these patients to provide evidence-based recommendations for this complex and unique cohort.
Localized molecular chaperone synthesis maintains neuronal dendrite proteostasis

Proteostasis is maintained through regulated protein synthesis and degradation and chaperone-assisted protein folding. However, this is challenging in neuronal projections because of their polarized morphology and constant synaptic proteome remodeling. Using high-resolution fluorescence microscopy, we discovered that neurons localize a subset of chaperone mRNAs to their dendrites and use microtubule-based transport to increase this asymmetric localization following proteotoxic stress. The most abundant dendritic chaperone mRNA encodes a constitutive heat shock protein 70 family member (HSPA8). Proteotoxic stress also enhanced HSPA8 mRNA translation efficiency in dendrites. Stress-mediated HSPA8 mRNA localization to the dendrites was impaired by depleting fused in sarcoma—an amyotrophic lateral sclerosis-related protein—in cultured mouse motor neurons and expressing a pathogenic variant of heterogenous nuclear ribonucleoprotein A2/B1 in neurons derived from human induced pluripotent stem cells. These results reveal a crucial and unexpected neuronal stress response in which RNA-binding proteins increase the dendritic localization of HSPA8 mRNA to maintain proteostasis and prevent neurodegeneration.
Liver iron overload and fat content analyzed by magnetic resonance contribute to evaluatingthe progression of chronic hepatitis B

Chronic hepatitis B (CHB) and its complications still have a major role in liver-related mortality. It has been indicated that hepatic iron and steatosis may influence liver fibrosis and carcinogenesis. The present study aimed to assess the liver iron and fat in patients with CHB by MRI in order to estimate the associations among liver iron, fat and the severity and progression of liver fibrosis. In the present retrospective study, consecutive patients with CHB examined from August 2018 to August 2020 were analyzed. Liver iron and fat content were assessed by MRI, which was measured as liver iron content (LIC) and proton density fat fraction (PDFF). A total of 340 patients were included in the current study. For LIC, the median value was 1.68 mg/g and elevated LIC was seen in 122 patients (35.9%). For liver fat content, the median value of PDFF was 3.1%, while only 15.0% of patients had liver steatosis (PDFF ≥5%). Age, total bilirubin and sex were independent predictive factors of liver iron overload [odds ratio (OR)=1.036, 1.005 and 8.834, respectively]. A higher platelet count (OR=1.005) and no portal hypertension (OR=0.381) independently predicted liver steatosis. The areas under the receiver operating characteristic curves of PDFF for the identification of liver cirrhosis estimated by different non-invasive tools ranged from 0.629 to 0.704. It was concluded that iron overload was common in patients with CHB, particularly in those with older age, male sex and high total bilirubin level, and liver steatosis was less common in CHB. Liver iron and fat content analyzed by MRI may contribute to the evaluation of the severity and progression of CHB.
Hepatocyte ballooning and steatosis in early and late gestation without liver malfunction: Effects of low protein/high carbohydrate diet

Pregnancy is a challenging metabolic and physiological condition. The aim of this study was to include a second demanding situation as a low protein/high carbohydrate diet (LPHCD) to characterize the histological and functional responses of the maternal liver. It is unknown how the maternal liver responds during early and late pregnancy to LPHCD intake. We explored early pregnancy (3 and 8 gestational age, G) and late pregnancy (15 and 20 G). The results indicated that pregnant rats under control diet showed an evident presence of ballooned hepatocytes, lipid vesicles and edema at late pregnancy (15G); in contrast, pregnant rats under LPHCD showed similar pattern of histological modification but at early pregnancy (3G). Unexpectedly, the serum biomarkers didn’t display functional alterations in either group, despite of the evident histological changes no liver malfunction was detected. We conclude that pregnant rats fed with control diet and experimental LPHCD, are subjected to metabolic and physiological conditions that impact the histopathological condition of the maternal liver. Control diet promoted the histological modifications during late pregnancy whereas LPCHCD advanced the onset of these changes. Further experiments are needed to explore the biochemical mechanisms that underlie these histological modifications. Our results are also an example of the resilience associated with the pregnancy: since no functional hepatic alterations accompanied the histopathological changes, another conclusion is that no evident pathological condition was detected in this nutritional protocol.
Antibiotic susceptibility patterns of pathogens isolated from hospitalized patients with advanced HIV disease (AHD) in Bihar, India

Abstract Objectives To describe the prevalence of common bacterial pathogens and antibiotic susceptibility patterns amongst advanced HIV disease (AHD) patients admitted between May 2019 and March 2021 to a Médecins Sans Frontières (MSF)-supported AHD inpatient unit in Bihar, India. Methods A retrospective analysis of routinely collected demographic, clinical and microbiological data. Antibacterial susceptibility testing was done by an accredited referral laboratory using the modified Kirby–Bauer disc diffusion method. Results A total of 238 isolates from 577 patients were identified through culture testing. Patient median (IQR) age was 38 (31–45) years, and 75% were male. Predominant sample types included blood (600; 38%), urine (266; 17%) and sputum (178; 11%). Of the isolated bacteria, Escherichia coli (80; 13.9%) was the most prevalent, followed by Klebsiella pneumonia (54; 9.4%), Pseudomonas aeruginosa (22; 3.8%), Klebsiella oxytoca (10; 1.7%), Proteus mirabilis (9; 1.6%), and Acinetobacter baumannii (7; 1.2%). The resistance pattern showed that most bacterial isolates were highly resistant to commonly prescribed antibiotics such as third-generation cephalosporins, fluoroquinolones and co-trimoxazole. Most pathogens were moderately resistant to antibiotics from the WHO Watch group, such as meropenem and piperacillin/tazobactam. In contrast, isolates were more susceptible to aminoglycosides, such as amikacin, gentamicin and nitrofurantoin. Conclusions In Bihar, inpatients with AHD displayed a concerning array of antibiotic-resistant infections. This study provides a starting point from which further work on antimicrobial resistance in this vulnerable cohort of patients can be conducted.
Antimony, Arsenic and Mercury Polluton in Agricultural Soil of Antimony Mine Area in Xikuangshan,Hunan

A field survey and analysis of soils were conducted to investigate the pollution of antimony,arsenic and mercury in agricultural soils of antimony mine area in Xikuangshan,Hunan Province.It was found that the three heavy metals were significantly elevated in soil samples(141.92-8733.26 mg kg-1Sb、14.95-363.19 mg kg-1 As and 0.16-5.68 mg kg-1Hg),which all exceeded their background concentrations in soils of Hunan.The average concentrations of Sb and As were 695 times and 2.3 times higher than the maximum permissible ones in the standard soil samples of Holland respectively,while the content of Hg was close to the maximum permissible one(2.2 mg kg-1) in the latter.The concentrations of the three elements in soil samples of smelting area were the highest in the mining area、smelting area and ore tailing area.Based on the assessment of the three heavy metals contaminated soil samples by the using of Index of geoaccumulation,it was indicated that smelters and mining activities were the main sources of heavy metals pollution of agricultural soils in antimony mine area and antimony pollution played the most important role in heavy metal pollution of soils.
Reproductive and Productive Performance of Fogera Cattle in Lake Tana Watershed, North Western Amhara, Ethiopia

A study was undertaken in three districts (Dembia, Libo Kemkem and Fogera) in north eastern Amhara Ethiopia. The objective was to evaluate the productive and reproductive performance of Fogera cattle in the Lake Tana watershed at smallholder farmers' level. The study areas were purposively selected based on their potentiality of Fogera cattle population. A total of 126 households were considered. A cross-sectional survey and structured questionnaire were used for the study. The data were analysed using the Statistical Package for the Social Sciences (SPSS) version 20 (SPSS 2001). The overall reported age at sexual maturity, age at first calving, lactation length and calving interval were 47.24±0.85, 59.90+0.83, 10.48+0.17 and 25.52+0.52 months, respectively. The reproductive life span was 11.30+0.17 years. The age at puberty and reproductive life span for Fogera male cattle was 48.87+0.77 months and 6.79+0.1 years. The overall mean of lactation length of a cow and lactation length of first parity were 10.48±0.17 and 10.44±0.15, respectively. The reported lactation length of the cow were less than 6 months (2.4%), 6-9 months (32.4%), 10-12 months (63.7%) and greater than 12 months (1.5%). The calving intervals (CI) of cow were 12 months (2.8%), 18 months (10%), 24 months (67.8%) and 36 months (19.5%). The second and third parity of early, mid and late stage daily milk yield of Fogera cattle were (3.31±0.12, 3.40±0.14 and 2.41±0.16), (4.29±0.16, 3.52±0.12 and 3.39±0.14) and (4.98±0.18, 3.8±0.13 and 2.81±0.14), respectively. The overall early, mid and late stages of daily milk yield were 4.19±0.15, 3.57±0.13 and 2.87±0.15 kg, respectively. The major constraints were shortage of feed, disease outbreak and occurrences of drought, shortage of water during winter/healthy water, flooding during summer season, market and conflict by grazing land.
Care pathways of individuals with tuberculosis before and during the COVID-19 pandemic in Bandung, Indonesia

The COVID-19 pandemic is thought to have undone years’ worth of progress in the fight against tuberculosis (TB). For instance, in Indonesia, a high TB burden country, TB case notifications decreased by 14% and treatment coverage decreased by 47% during COVID-19. We sought to better understand the impact of COVID-19 on TB case detection using two cross-sectional surveys conducted before (2018) and after the onset of the pandemic (2021). These surveys allowed us to quantify the delays that individuals with TB who eventually received treatment at private providers faced while trying to access care for their illness, their journey to obtain a diagnosis, the encounters individuals had with healthcare providers before a TB diagnosis, and the factors associated with patient delay and the total number of provider encounters. We found some worsening of care seeking pathways on multiple dimensions. Median patient delay increased from 28 days (IQR: 10, 31) to 32 days (IQR: 14, 90) and the median number of encounters increased from 5 (IQR: 4, 8) to 7 (IQR: 5, 10), but doctor and treatment delays remained relatively unchanged. Employed individuals experienced shorter delays compared to unemployed individuals (adjusted medians: -20.13, CI -39.14, -1.12) while individuals whose initial consult was in the private hospitals experienced less encounters compared to those visiting public providers, private primary care providers, and informal providers (-4.29 encounters, CI -6.76, -1.81). Patients who visited the healthcare providers >6 times experienced longer total delay compared to those with less than 6 visits (adjusted medians: 59.40, 95% CI: 35.04, 83.77). Our findings suggest the need to ramp up awareness programs to reduce patient delay and strengthen private provide engagement in the country, particularly in the primary care sector.
Participants’ understanding of informed consent in clinical trials: A systematic review and updated meta-analysis

Obtaining written informed consent from participants before enrolment in a study is essential. A previous study showed that only 50% of the participants in clinical trials understood the components of informed consent, and the methods of participants’ understanding of informed consent were controversial. This updated meta-analysis aimed to estimate the proportion of participants in clinical trials who understand the different informed consent components. PubMed, EMBASE, the Cochrane Library, and Scopus were searched till April 2023. Therapeutic misconception, ability to name one risk, knowing that treatments were being compared, and understanding the nature of the study, the purpose of the study, the risks and side-effects, the direct benefits, placebo, randomization, voluntariness, freedom to withdraw, the availability of alternative treatment if withdrawn from the trial, confidentiality, compensation, or comprehension were evaluated. This meta-analysis included 117 studies (155 datasets; 22,118 participants). The understanding of the risks and side-effects was investigated in the largest number of studies (n = 100), whereas comparehension was investigated in the smallest number (n = 11). The highest proportions were 97.5%(95% confidence interval (CI): 97.1–97.9) for confidentiality, 95.9% (95% confidence interval (CI): 95.4–96.4) for compensation, 91.4% (95% CI: 90.7–92.1) for the nature of study, 68.1% (95% CI: 51.6–84.6) for knowing that treatments were being compared, and 67.3% (95% CI: 56.6–78) for voluntary nature of participants. The smallest proportions were the concept of placebo (4.8%, 95%CI: 4.4–5.2) and randomization(39.4%, 95%CI: 38.3–40.4). Our findings suggested that most participants understood the fundamental components of informed consent (study confidentiality, nature, compensation, voluntariness, and freedom to withdraw). The understanding of other components, such as placebo and randomization was less satisfactory.