Miracle-dz/UniFAR-FTUs huggingface dataset:
Lateral Soft Tissue Neck X-ray a Tool for the Otorhinolaryngology Surgeon

Background: Management of aerodigestive emergencies can prove a challenge especially in this sub-Saharan region where there is a dearth of specialized equipment. In some areas, a plain radiograph may be the only investigative tool readily available to the surgeon. It is routinely done in most of these cases. In our environment health care is often financed by the patients through out of pocket expenses since most do not have health insurance. Affordability of a particular treatment becomes paramount. This study, therefore, is aimed at assessing the use of lateral soft tissue neck X-ray and its reliability as a diagnostic tool in aerodigestive emergencies. Objective: To determine the relevance or effectiveness of plain radiograph of the lateral soft tissue neck in patients with upper aerodigestive emergencies and therefore its use as a tool to the otorhinolaryngology (ORL) surgeon as the first-line investigation in these patients. Patients and Methods: It is a prospective study of all patients that presented to the ENT surgery department of UPTH from April 2018 to April 2019 with upper aerodigestive emergencies. Patients who presented in the ENT clinic, accident and emergency department, children`s emergency wards and the clinics with upper aerodigestive emergencies were recruited in this study. All the patients had X-ray lateral soft tissue of the neck done on presentation and the results were then compared with the final operative findings in the operation theatre. Some patients had also chest radiograph done however; the diagnosis was done based on the lateral soft tissue neck finding. Patients that had radiologic investigation other than radiograph of the lateral soft tissue neck as the main investigative tool were excluded from the study. The radiologist opinion was obtained for all the radiographs as a routine. The results were analyzed using the SPSS 20 and presented in simple statistical tables. Results: Sixteen patients were studied. Males were 14(87.5%) while females were 2(12.5%). Age range was from 1.5 to 77 years with children comprising only 31.25% of the study population. The commonest presenting complaint was voice change 68.75%. Positive findings on the x-ray neck were seen as soft signs in 62.5% and radio-opacity in 18.75%. In n=14(87.5%) the lateral neck x-ray positive findings were corroborated by the operative findings. The tool has a specificity of 100% for both foreign body inhalation/ingestion and laryngeal tumour but the sensitivity of 80% in laryngeal tumours but 100% for the foreign body. Conclusion: Study concludes that lateral soft tissue neck x-ray was found to be a good and useful tool in the diagnosis of a good number of upper aerodigestive emergencies such as foreign body ingestion/inhalation and patients with upper airway obstruction caused by laryngeal tumours and some infective conditions such as a retropharyngeal abscess.
Learning effects of the flipped classroom in a principles of microeconomics course

Abstract The authors of this article estimate the learning effects of the flipped classroom format using data from 16 sections of principles of microeconomics over a 4-year period. The experimental design is unique in that two treatment and two control sections were taught during the fall semester in four consecutive years. Further, the instructor switched the time of day when the treatment and control sections were taught each year. Controlling for gender, ACT score, a normed high school GPA, Pell Grant award, time of day, and initial knowledge of economics, the authors find no evidence of increased learning using end-of-semester measures for students in the flipped classroom in comparison to sections with a moderate amount of active learning.
ROLE OF TRUST IN BANK-SME RELATIONSHIPS Master’s Thesis

According to Degryse and Cayseele (2000) small businesses often complain about being unable to get money from banks at affordable rates. They argue, that borrowers can mitigate the problem by building a strong relationship with the lender. Having access to sufficient debt financing is crucial for small and medium sized enterprises (SMEs). However, evaluating the creditworthiness of SMEs is a challenge for banks, because the availability of public information is much lesser than in case of larger corporations and with enterprises, that have a long history. Previous studies argue, that in addition to the (mandatory) hard data, banks should utilize private information such as growth estimates, immaterial rights and innovations. However, the SMEs often think that this kind of information is sensitive, and they do not want it to end up in the wrong hands. Because of trust issues the SMEs might not be willing to provide banks with this additional information. Scholars argue, that if the SMEs trust their banks and provide them this additional information, they are more likely to obtain the credit they need. This study aims to find out what is the role of trust in the bank-SME relationships. The context of this study is Finnish society where trust is high and the bank-SME relationships; the institutions that give the loans, the companies that need the loans and the relationships between these two entities. There is a lot of literature on trust itself, but there is a limited understanding of the role of trust in SME financing and this study will contribute to that area of research. The research in understanding the startup and SME financing has been increasing, but a limited understanding of the area remains.
Defining the real needs of women smallholder farmers in Vietnam: the importance of grassroots participation and multi-stakeholder collaboration

In response to gender gap and hardship due to heavy production and domestic tasks of women smallholder farmers in developing countries, this study was conducted under the auspices of the Gates Foundation with an original goal of formulating labour saving strategies and innovations for the rural women in Vietnam. The first five steps of a systemsbased Evolutionary Learning Laboratory (ELLab) framework together with other management tools were employed in the first phase of the project during April 2013 to April 2014. The project has identified actual challenges and needs of the target group using appropriate systems approaches, including a flexible use of stakeholder analysis and engagement, and a log-frame approach for evaluation. Interestingly, saving labour was not identified as the highest priority for the women and was ranked second after the need for increasing their income. The outcomes of the study served as feedback and a rationale for reframing the project goal and objectives to address the ‘real issues’, ‘real needs’ and thus appropriate intervention strategies to address the identified challenges of the women farmers in the research area. Process steps of issue identification, rethinking and reframing of the project approach, goals and objectives are discussed and analyzed to prove the value and validity of the unique ELLab processes as an appropriate framework to deal with complex problems in the context of interconnected economic, environmental, social and cultural factors. The findings have not only brought about practical solutions for the women, but also formulated context-based recommendations for funding agencies and local governments.
University of Birmingham Application of pattern recognition techniques for classification of paediatric brain tumours by in vivo 3T 1H MRS – A multi centre study

Citation for published version (Harvard): Zarinabad, N, Abernethy, LJ, Avula, S, Davies, N, Gutierrez, DR, Jaspan, T, Macpherson, L, Mitra, D, Rose, H, Wilson, M, Morgan, PS, Bailey, S, Pizer, B, Arvanitis, T, Grundy, RG, Auer, DP & Peet, A 2018, 'Application of pattern recognition techniques for classification of paediatric brain tumours by in vivo 3T 1H MRS – A multi centre study', Magnetic Resonance in Medicine, vol. 79, no. 4, pp. 2359-2366. https://doi.org/10.1002/mrm.26837
CEO Compensation, Strategy, andFirm Performance

CEOs are increasingly being granted options as part of their compensation packages. However, despite all of the research conducted on executive compensation, there has been little investigation into the impact of CEO stock option grants on firm performance. In addition, many previous studies have found conflicting results on the impact of equity-based compensation on performance. Our study incorporates the competitive strategy adopted by the firm into its analysis. We document that a firm’s strategy impacts the level of stock options granted to the CEO. We also found that, after controlling for a firm’s competitive strategy, the relationship between CEO stock options and firm performance is stronger than when the sample is considered on a pooled basis.
Thyroid Cancer: Is Really Less More?

Submit Manuscript | http://medcraveonline.com followed in patients with thyroid nodules and specifically the widespread adoption and use of fine needle aspiration [4]. As a result of the “over diagnosis” of these small indolent tumors, the excellent prognosis and clinical outcome of these patients and a non-negligible percentage of surgical complications, there is growing evidence to suggest active surveillance as an alternative to immediate surgery in a specific subgroup of patients [5,6]. It comes as no surprise that the aforementioned alternative therapeutic approach in specific subtypes of thyroid cancer has been recently advocated by the findings of a multidisciplinary, retrospective study of patients with thyroid nodules diagnosed as encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) and reclassified as “non-invasive follicular thyroid neoplasm with papillary-like nuclear features” (NIFTP) [7].
Chapter 4 ESRD prevalent rates in 2007 in the UK: national and centre-specific analyses

Introduction: This chapter describes the demographics of UK RRT patients in 2007. Methods: Complete data were electronically collected from 71 UK centres with the remaining 1 centre submitting summary data. A series of crosssectional and longitudinal analyses were performed to describe the demographics of prevalent UK RRT patients in 2007 at a centre and a national level. Results: There were 45,484 adult patients receiving RRT on 31/12/2007. The population prevalence for adults was 746 per million population per year (pmp) with an annual increase in prevalence of approximately 5% per annum. There was substantial variation in standardised prevalence ratios between Primary Care Trust (PCT)/Health Authority (HA) areas which were associated with geographical factors and differences in ethnicity with mean standardised prevalence ratios (SPR) significantly higher in PCTs/HAs with a high proportion of ethnic minorities. The median age of prevalent RRT patients was 57 years (HD 65 years, PD 60 years, transplant 50 years). Median RRT vintage was 5.3 years (HD 2.8 years, PD 2.1 years, transplant 10.4 years). For all ages, crude prevalence rates in males exceeded those in females, peaking in the 75–79 year age band for males at 2,506 pmp and in females in the 70–74 year age band at 1,314 pmp. The most common identifiable diagnosis was glomerulonephritis (15.3%) but in those over 65 it was diabetes (15.1%). The most common treatment modality was transplantation (46.6%), closely followed by centrebased HD (42.1%) in either the primary centre (25.2%) or the satellite unit (16.9%). The HD population has continued to expand, and the PD population to contract. HD was increasingly prominent with increasing age at the expense of transplantation. Conclusions: There were national, area and dialysis centre level variation in the prevalent UK RRT population. This has implications for service planning and ensuring equity of care for RRT patients.
ALTERATIONS IN DISC HEIGHT, FORAMINAL HEIGHT AND FORAMINAL WIDTH FOLLOWING ONE- AND TWO-LEVEL AXIALIF: A RADIOLOGICAL ANALYSIS

Purpose Degenerative changes of the lumbar motion segment often lead to stenosis of the spinal canal or neuroforamen. Axial lumbar interbody fusion (AxiaLIF) is intended to indirectly increase and stabilize foraminal dimensions by restoring disc height in patients with degenerative disc disease, thereby relieving axial and radicular pain. Therefore, this study investigated the effects of AxiaLIF on anterior disc height, posterior disc height, foraminal height and foraminal width as well as to determine the effectiveness of this minimally-invasive technique for indirect decompression and restoration of disc height. Method Eighty-one patients who underwent a 360 degree lumbar interbody fusion at L4-S1 and L5-S1 with AxiaLIF between November 2008 and May 2010 and satisfied all inclusion criteria were included. The preoperative and three-month postoperative digital radiographs were reviewed and analyzed. Disc heights were measured in the planes of the anterior and posterior surfaces of the adjacent vertebral bodies. Foraminal height was measured as the maximum distance between the inferior margin of the pedicle of the superior vertebra and the superior margin of the pedicle of the inferior vertebra. Foraminal width was measured as the shortest distance between the edge of the superior facet of the caudal vertebra and the posterior edge of inferior endplate of the cranial vertebra. Potential magnification error between pre- and post-operative radiographs was corrected using the anterior vertebral height of L5 vertebra. Results Our study shows that there is a mean increase of 42.0% in posterior disc height (PDH) at L4-5 and 21.5% in anterior disc height (ADH) at L4-5 and PDH mean increase of 33.6% and 16.3% in ADH at L5-S1 in two-level AxiaLIF cases. Similarly the mean change in foraminal height (FH) was 12.6% at L4-5 and 10.8% at L5-S1 in 2-levels AxiaLIF. The mean change in foraminal width (FW) at L4-L5 was 19.9% and 29.1% at L5-S1 in 2-levels AxiaLIF. In the single level AxiaLIF group, the mean change in PDH was 43.1%, the ADH change was 17.5%, the average change in FH was 14.4%, and mean change in FW was 25.3%. The change is reflected as a percentage of the preoperative value. All changes from preoperative to postoperative values were statistically significant. Conclusion AxiaLIF appears to be an effective minimally invasive device to increase disc height and neuroforaminal area. Our findings appear equivalent to anterior lumbar interbody fusion and transforaminal lumbar interbody fusion in terms of indirect decompression and increase in disc height. This, in combination with the added benefit of preserving the annulus, anterior longitudinal ligament, and posterior longitudinal ligament, suggests the AxiaLIF is an excellent alternative for this patient population. However, additional follow-up studies are necessary to confirm the long-term ability of the implant to maintain fusion and preserve the improvements in disc and foraminal area.
Acceptability and Feasibility of a Meaning-Based Intervention for Patients With Advanced Cancer and Their Spouses

Background: Constructing meaning in cancer leads to improved psychosocial outcomes for patients and survivors. Aim: We tested the feasibility and preliminary efficacy of a meaning-based intervention for couples. Design: The single-arm pilot study tested a 4-session, tailored, activities-based couple’s intervention. Setting/Participants: Twelve adults with incurable cancer and their partners participated either in a university office or at the couple’s home. Results: The study showed good feasibility. One of the two patients depressed at baseline was no longer depressed at postintervention. Patients’ threat appraisals decreased and transcendence increased. In partners, depression, anxiety, and challenge appraisal decreased; threat and secondary appraisals and peace with illness increased. Conclusions: Our findings suggest feasibility and efficacy, and further research and continued evaluation of this intervention are warranted.
Diagnosis klinis awal : dari masalah menuju diagnosis

Membuat diagnosis yang tepat tidaklah mudah. Banyak tahapan yang harus dilakukan, mulai dari masalah yang dikeluhkan pasien hingga ditegakkannya diagnosis. Buku ini sangat membantu para mahasiswa untuk menegakkan diagnosis yang tepat. Topik yang dibahas disajikan secara sistematis dan ringkas sehingga mudah dimengerti dan diingat. Disajikan juga bagan-bagan yang menunjukkan alur penegakan diagnosis beberapa penyakit. Buku ini dapat menjadi pelengkap catatan kuliah sehingga diharapkan dapat membantu mahasiswa selama menempuh pendidikan kedokteran.
Medication adherence among diabetic and hypertensive patients in Al-Qassim region of Saudi Arabia

Non-adherence to medication is often an unrecognized risk factor that contributes to failure of the therapeutic plan. The purpose of the study was to identify factors related to high, medium and low medication adherence among adult Saudi patients with hypertension and diabetes mellitus. This study is designed as a descriptive cross sectional survey and was conducted in three tertiary care hospitals of Al-Qassim province of Saudi Arabia. The data was collected using the 8-item Morisky Medication Adherence Scale (MMAS-8) and analyzed by SPSS. Three levels of adherence were considered based on the following scores: 0 to <6 (low); 6 to <8 (medium); 8 (high). Of the 396 patients interviewed, 52% reported low adherence to prescribed medication. Multinomial logistic regression analysis was conducted. Gender, age, literacy level, duration of illness and type of chronic disease were negatively associated with medication adherence. The study shows very high proportion of low and medium adherence on long term medication, which may be responsible for the failure of achieving therapeutic outcome. Further investigation is required to evaluate the applicability of MMAS-8 as a tool of measuring medication adherence among Saudi patients with chronic diseases. Adherence enhancing strategies should also be evaluated in separate patients group.
Adrenocortical Carcinoma, 40-Year Experience of a Canadian Tertiary Cancer Centre

Purpose: To review a single Tertiary Cancer Centre experience in management of ACC treated over a period of 40 years. To review literature foravailable guidelines for treatment of ACC and available evidence for adjuvant RT. Methods: A retrospective chart review for ACC patient treated in single cancer centre between January 1974 and December 2013 was conducted. Patients demographic and tumour characteristics were extracted. Date of referral to Cancer Center and primary and adjuvant treatment modalities were recorded. Outcome data including dates and sites of failure, vital status, and cause of death were collected. Overall survival (OS) and disease free survival (DFS) curves were created using Kaplan Meier test. A Medline search using pub-med, Ovid, and Embase was carried out to review literature regarding the role of RT and any available management guidelines. Results: Out of 81 patients identified in the database, 39 had confirmed ACC. Thirty-two patients had surgical resections including two with M1 disease. Among the patients who did not have surgical resection, 4 patients were metastatic and two were non-resectable or medically inoperable. Out of the 32 patients who had surgeries, 16 had adjuvant systemic treatment including mitotane or concurrent chemo-radiation Only 6 patients had adjuvant RT, of whom 3 are still alive (2 of them alive with distant failure). At median follow up period of 3.8 years, 28 patients died (71%), 10 are alive (25%) and one lost follow up. Of the 22 patients with failure data, 2 had local failure and the rest had distant failure. Conclusion: The current data is insufficient to make treatment recommendation. Collaborative database and consensus on diagnostic and therapeutic guideline is warranted for better identification of optimum management. Adjuvant radiation therapy could be a reasonable option for R1 disease, and randomized controlled trial is needed.
Nursing Staffs' Knowledge and Practice Regarding Prevention of Hepatitis (C) Virus Transmission in Hemodialysis Units

Aims and objectives. To assess nursing staffs' knowledge and practice regarding the prevention of hepatitis C virus (HCV) transmission in hemodialysis units (HDUs). Design. A descriptive exploratory study was utilized to fulfill the aim of the study. Subjects. A convenient sample consisted of all hemodialysis nurses (55 nurses) in three HD units at Cairo University Hospital, Egypt. Tools. Two instruments were designed to collect data pertinent to the study: a) Self-administered questionnaire to assess the subjects‟ level of knowledge, and b) Observational checklist, used to assess subjects‟ level of practice. Results. Showed that (54.5%) of the studied subjects have got a satisfactory level of knowledge regarding prevention of HCV transmission, while all of them (100%) have got an unsatisfactory level of practice related to prevention of HCV transmission in HD units. Recommendations. In-service training program should be designed and implemented regularly to all hemodialysis nurses.
SenseNet: Deep Learning based Wideband spectrum sensing and modulation classification network

—Next generation networks are expected to operate in licensed, shared as well as unlicensed spectrum to support spectrum demands of a wide variety of services.Due to shortage of radio spectrum, the need for communication systems(like cognitive radio) that can sense wideband spectrum and locate desired spectrum resources in real time has increased. Automatic modulation classiﬁer (AMC) is an important part of wideband spectrum sensing (WSS) as it enables identiﬁcation of incumbent users transmitting in the adjacent vacant spectrum.Most of the proposed AMC work on Nyquist samples which need to be further processed before they can be fed to the classiﬁer. Working with Nyquist sampled signal demands high rate ADC and results in high power consumption and high sensing time which is unacceptable for next generation communication systems.To overcome this drawback we propose to use sub-nyquist sample based WSS and modulation classiﬁcation. In this paper, we propose a novel architecture called SenseNet which combines the task of spectrum sensing and modulation classiﬁcation into a single uniﬁed pipeline. The proposed method is endowed with the capability to perform blind WSS and modulation classiﬁcation directly on raw sub-nyquist samples which reduces complexity and sensing time since no prior estimation of sparsity is required. We extensively compare the performance of our proposed method on WSS as well as modulation classiﬁcation tasks for a wide range of modulation schemes, input datasets, and channel conditions. A signiﬁcant drawback of using sub-nyquist samples is reduced performance compared to systems that employ nyquist sampled signal.However,we show that for the proposed method,the classiﬁcation accuracy approaches to Nyquist sampling based deep learning AMC with an increase in signal to noise ratio.