Miracle-dz/UniFAR-FTUs huggingface dataset:
Generational characteristics of general medicine students in Iran

BACKGROUND: Purpose: The success of any educational system depends on the fitness of the curriculum components with the characteristics of its audience. The students of the present generation are different from the previous ones due to the changes resulting from the changes that have taken place in society, media, technology, and communication as we entered the 21th century. Hence, this study was conducted to identify the characteristics of MD students in universities of medical sciences in Iran. MATERIALS AND METHODS: This qualitative study was conducted on 32 MD students among 7 universities of medical universities of Iran. The participants were selected through purposive sampling method, and the data were collected via semi-structured interviews after getting informed consent. Then, the data were analyzed using conventional content analysis method. RESULTS: Technology as a Double-Edged Sword, in digital age, Quick access, Reasoning the basis of acceptance. Evaluation ambiguity, Seeking independence,get involved in problems, desirable teaching qualities, my favorite teacher, features of content, Role models traces,my favorite teacher, The rest are unchanged. CONCLUSION: MD students are interested in using various teaching methods and technologies, applying methods that are similar to their future job and learning by doing; they also tend to use visual materials and shortening the time and memorizing content. They prefer professors who love to teach and are good role models for them. What motivates them is to be involved in the classroom, to be active, to be respected, and not to be ignored.
Magnitude and associated factors of urinary tract infections among adults living with HIV in Ethiopia. Systematic review and meta-analysis

Background Urinary tract infection is a major public health problem in developing countries among immunocompromized populations where there are limited health-care services. People living with human immunodeficiency virus (HIV) are more likely to develop urinary tract infections (UTI) due to the suppression of their immunity. There is no single representative figure as well as the presence of significant heterogeneity among studies conducted on people living with HIV in Ethiopia. Hence, this study tried to pool the magnitude of UTI among people living with HIV in Ethiopia. Method To find relevant studies, researchers looked through Web of Science, Science Direct, PubMed, EMBASE, the Cochrane Library, Google Scholar, and Worldwide Science. The I2 statistic was used to examine for heterogeneity among the studies that were included. To evaluate the pooled effect size across studies, a random-effects model was used. The presence of publication bias was determined using a funnel plot and Egger’s regression test. STATATM version 14.0 software was used for all statistical analyses. Results A total of 7 studies with 2257 participants were included in this meta-analysis. UTI was shown to be prevalent in 12.8% (95% CI: 10.8–14.79, I2 = 50.7%) of HIV patients. Being male (0.35, 95% CI:0.14, 1.02), rural residents(OR:1.41,95% CI: 0.85, 2.34), no history of catheterization (OR: 0.35, 95% CI: 0.06, 1.85), had no history of DM (OR:0.84, 95% CI:0.12, 0.597) and having CD4 count greater than 200 (OR:0.36 95% CI: 0.06, 2.35) were the factors which were the associated factors assessed and having association with UTI among people living with HIV but not statistically significant. Conclusions In Ethiopia, one in every eight HIV-positive people is at risk of acquiring UTI. Regardless, we looked for a link between sex, residency, CD4, catheterization history, and DM and UTI, but there was none. To avoid this phenomina, every HIV patient should have a UTI examination in every follow-up.
Spontaneous rate of clonal single nucleotide mutations in Daphnia galeata

Mutations are the ultimate source of heritable variation and therefore the fuel for evolution, but direct estimates of mutation rates exist only for few species. We estimated the spontaneous single nucleotide mutation rate among clonal generations in the waterflea Daphnia galeata with a short-term mutation accumulation approach. Individuals from eighteen mutation accumulation lines over five generations were deep sequenced to count de novo mutations that were not present in a pool of F1 individuals, representing the parental genotype. We identified 12 new nucleotide mutations in 90 clonal generational passages. This resulted in an estimated single nucleotide mutation rate of 0.745 x 10−9 (95% c.f. 0.39 x 10−9–1.26 x 10−9), which is slightly lower than recent estimates for other Daphnia species. We discuss the implications for the population genetics of Cladocerans.
Validation of xMAP SARS-CoV-2 Multi-Antigen IgG assay in Nigeria

Objective There is a need for reliable serological assays to determine accurate estimates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence. Most single target antigen assays have shown some limitations in Africa. To assess the performance of a multi-antigen assay, we evaluated a commercially available SARS-CoV-2 Multi-Antigen IgG assay for human coronavirus disease 2019 (COVID-19) in Nigeria. Methods Validation of the xMAP SARS-CoV-2 Multi-Antigen IgG assay was carried out using well-characterized SARS-CoV-2 reverse transcription polymerase chain reactive positive (97) and pre-COVID-19 pandemic (86) plasma panels. Cross-reactivity was assessed using pre-COVID-19 pandemic plasma specimens (213) from the 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS). Results The overall sensitivity of the xMAP SARS-CoV-2 Multi-Antigen IgG assay was 75.3% [95% CI: 65.8%– 82.8%] and specificity was 99.0% [95% CI: 96.8%– 99.7%]. The sensitivity estimate increased to 83.3% [95% CI: 70.4%– 91.3%] for specimens >14 days post-confirmation of diagnosis. However, using the NAIIS pre-pandemic specimens, the false positivity rate was 1.4% (3/213). Conclusions Our results showed overall lower sensitivity and a comparable specificity with the manufacturer’s validation. There appears to be less cross-reactivity with NAIIS pre-pandemic COVID-19 specimens using the xMAP SARS-CoV-2 Multi-Antigen IgG assay. In-country SARS-CoV-2 serology assay validation can help guide the best choice of assays in Africa.
Limited access to improved drinking water, unimproved drinking water, and toilet facilities among households in Ethiopia: Spatial and mixed effect analysis

Background Most people in sub-Saharan countries had limited drinking water services and toilet facilities. The collection of water can affect the health of the whole family, particularly children. Therefore this study aims to investigate determinants of limited access to drinking water services and spatial distributions of limited access to drinking water services, unimproved drinking water sources, and toilet facilities among households in Ethiopia. Method Cross-sectional collected secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey (EDHS). A mixed-effect logistic regression model was used for analysis. The total weighted sample of 10, 183 households was included in the analysis. The study population is comprised of all households who had recorded the time taken to fetch improved drinking water during the survey. The primary outcome of this study is the proportion of households that have limited access to drinking water services. Whereas the secondary outcomes are determinants of limited access to drinking water services and spatial distributions of limited drinking water services, unimproved drinking water sources, and toilet facilities among households in Ethiopia. Results In this study, 39.74% [95% CI: 38.79, 40.69] of households in Ethiopia had limited access to drinking water services. This proportion ranges from 2.64% in Addis Ababa to 57.35% in the Somali region. Household head, education, residence, and regions were associated with limited access to drinking water services. The spatial analysis showed that the eastern part of Amhara, Afar and the Somali region predicted the highest limited drinking water services. The unimproved drinking water source was detected in the Central part of Amhara, Somalia regions. Almost all regions except Addis Ababa and Diredewa predicted the highest prevalence of unimproved toilet facilities. Conclusion Access to improved drinking water is relatively poor throughout Ethiopia, with some regions experiencing more limited access than others. From individual level variables age, educational level, and sex household head, whereas from community level variables residences, and region were factors significantly associated with access to limited drinking water services. The spatial analysis confirmed that there are inequalities in unimproved drinking water sources, and toilet facilities between regions in Ethiopia. The government of Ethiopia should work to increase the accessibility of improved drinking water at the national level and to narrow the gap in its accessibility between urban and rural residences and between regions. Accessibility to drinking water programs should focus on the disadvantaged group such as non-educated, male head households and living rural residences. All stalk holders should work to improve the quality of drinking water and sanitation facilities.
Design, management and completion of the HypoCOMPaSS RCT evaluating potential for restoration of hypoglycaemia awareness in type 1 diabetes using conventional vs novel technologies : and exploration of potential phenotypes predicting persistent impaired awareness despite study intervention

Aim: To explore the extent to which impaired awareness of hypoglycaemia (IAH) can be improved using currently available treatment regimens in individuals with long-standing type 1 diabetes mellitus (T1DM), and to characterise those individuals whose awareness of hypoglycaemia did not improve. Methods: A multicentre, 2x2 factorial 24-week RCT (HypoCOMPaSS) comparing multiple daily injections (MDI) and continuous subcutaneous insulin infusion therapy (CSII) with or without real-time continuous glucose monitoring (RT) in a population with T1DM and IAH was designed. The study was undertaken in five UK centres using established and novel outcome measures to assess hypoglycaemia awareness, glycaemic control and treatment satisfaction. A second analysis was undertaken characterising individuals within the HypoCOMPaSS population as responders and non-responders. Complication status, autonomic symptom profile and hyperglycaemia avoidance scores were assessed. Results: Overall, hypoglycaemia awareness improved, and biochemical hypoglycaemia, severe hypoglycaemia rate and insulin doses reduced without deterioration in HbA1c. There were no significant differences in awareness comparing MDI with CSII; and RT with conventional glucose monitoring. Between-group analyses demonstrated comparable reductions in severe hypoglycaemia, biochemical hypoglycaemia, fear of hypoglycaemia and insulin doses with equivalent HbA1c. Treatment satisfaction was highest with CSII. In the second study there was a suggestion that longer diabetes duration and increased age may impair ability to respond to the interventions but this did not correlate with severity of autonomic symptoms. Conclusions: Hypoglycaemia awareness can be improved and recurrent severe hypoglycaemia prevented in long-standing T1DM without relaxing HbA1c. Similar biomedical outcomes can be attained with conventional MDI and SMBG regimens compared with CSII / RT. All individuals may benefit from biomedical interventions to improve awareness of hypoglycaemia. This
The perceived benefits of Automotive Service Excellence (ASE) certifications for graduates of four-year Automotive Technology programs

The roots of certification in America date back to guild-like associations similar to those in Europe, but did not gain industry recognition until after World War II. It is recognized as a way for an industry to elevate itself and be recognized as a stand-alone, autonomous profession, as long as there is validity in the process and impartial oversight by an accredited governing body. It is also a way for individuals to distinguish themselves from their peers by proving a technical aptitude or competence. It allows a prospective job candidate to signal to a potential employer that they have attained of higher body of knowledge held to national standards. Certification can be required or not in a wide array of industries and professions, but is generally not required in the automotive industry except for pockets of technical positions in the automotive manufacturing and service sectors. The certification agency in the automotive industry is the National Institute for Automotive Service Excellence which was established in 1972 as an independent, non-profit organization charged with oversight and the administration of the Automotive Service Excellence (ASE) exams. The costs of the examinations and the registration fees can add up, they can be quite challenging for even the seasoned professional, and recertification is required every five years. The purpose of this study was to identify and analyze the perceived benefits of earning these certifications for 4-year automotive technology graduates working in the automotive or automotive-related industry.
Healthcare resource use of patients with transthyretin amyloid cardiomyopathy

Transthyretin amyloid cardiomyopathy (ATTR‐CM) is the cardiac manifestation of transthyretin amyloidosis (ATTR). The aim of this study was to estimate healthcare resource use for ATTR‐CM patients compared with heart failure (HF) patients, in Denmark, Finland, Norway, and Sweden.
Simplified hypertension screening methods across 60 countries: An observational study

Background Simplified blood pressure (BP) screening approaches have been proposed. However, evidence is limited to a few countries and has not documented the cardiovascular risk amongst missed hypertension cases, limiting the uptake of these simplified approaches. We quantified the proportion of missed, over-diagnosed, and consistently identified hypertension cases and the 10-year cardiovascular risk in these groups. Methods and findings We used 60 WHO STEPS surveys (cross-sectional and nationally representative; n = 145,174) conducted in 60 countries in 6 world regions between 2004 and 2019. Nine simplified approaches were compared against the standard (average of the last 2 of 3 BP measurements). The 10-year cardiovascular risk was computed with the 2019 World Health Organization Cardiovascular Risk Charts. We used t tests to compare the cardiovascular risk between the missed and over-diagnosed cases and the consistent hypertension cases. We used Poisson multilevel regressions to identify risk factors for missed cases (adjusted for age, sex, body mass index, and 10-year cardiovascular risk). Across all countries, compared to the standard approach, the simplified approach that missed the fewest cases was using the second BP reading if the first BP reading was 130–145/80–95 mm Hg (5.62%); using only the second BP reading missed 5.82%. The simplified approach with the smallest over-diagnosis proportion was using the second BP reading if the first BP measurement was ≥140/90 mm Hg (3.03%). In many countries, cardiovascular risk was not significantly different between the missed and consistent hypertension groups, yet the mean was slightly lower amongst missed cases. Cardiovascular risk was positively associated with missed hypertension depending on the simplified approach. The main limitation of the work is the cross-sectional design. Conclusions Simplified BP screening approaches seem to have low misdiagnosis rates, and cardiovascular risk could be lower amongst missed cases than amongst consistent hypertension cases. Simplified BP screening approaches could be included in large screening programmes and busy clinics.
Cognitive reserve, cognition, and real-world functioning in MCI: A systematic review and meta-analysis

ABSTRACT Objective To synthesize quantitatively the mild cognitive impairment (MCI) literature with respect to the relationship between cognitive reserve and neuropsychological and functional outcomes. Method Participants with a diagnosis of MCI (total n = 7,871; 53% female) were included in this random-effects meta-analysis. Neuropsychological measures were combined into composite scores (e.g., overall cognitive functioning, screening measures, memory, language, visuospatial, attention/processing speed/working memory, executive functioning, and motor functioning). Measures assessing real-world abilities were combined into an activities of daily living (ADL) composite. Results Nearly all neuropsychological composite values were significantly correlated with education, with effect sizes ranging from small to moderate. The effect between overall neuropsychological functioning and occupation was weak and varied by cognitive domain. For cognitively stimulating leisure activity, only overall neuropsychological functioning demonstrated a significant relationship, with a weak effect size (r = .16). In contrast, ADLs were most strongly associated with leisure experience (r = .27), with a negligible relationship with education (r = 0.08) and occupation (r = 0.09). Conclusions Of the cognitive reserve proxies examined in this study, participation in leisure activity had the largest magnitude of effect size with ADL functioning. This was in stark contrast to the negligible relationship found for education and occupation. Although education has been widely considered the most important cognitive reserve proxy with respect to cognition, this work questions whether other lifestyle factors may play a more important role in preserving real world functioning.
Field Experience with and Potential for Multi-time Scale Grid Transactions from Responsive Commercial Buildings:

The need for and concepts behind demand response are evolving. As the electric system changes with more intermittent renewable electric supply systems, there is a need to allow buildings to provide more flexible demand. This paper presents results from field studies and pilots, as well as engineering estimates of the potential capabilities of fast load responsiveness in commercial buildings. We present a sector wide analysis of flexible loads in commercial buildings, which was conducted to improve resource planning and determine which loads to evaluate in future demonstrations. These systems provide important capabilities for future transactional systems. The field analysis is based on results from California, plus projects in the northwest and east coast. End-uses considered include heating, ventilation, air conditioning and lighting. The timescales of control include day-ahead, as well as day-of, 10-minute ahead and even faster response. This technology can provide DR signals on different times scales to interact with responsive building loads. We describe the latency of the control systems in the building and the round trip communications with the wholesale grid operators.
TBK1’s Role in Bacterial Pneumonia: Perhaps More than Macrophages and IFNs

Pneumococcal pneumonia continues to be a life-threatening illness. Although an early antibacterial immune response is critical for controlling infection and preserving organ function, excessive and timely unrestricted inflammation can lead to severe lung injury (1). A better understanding of the signaling pathways regulating inflammatory responses is therefore desirable, as it might help us develop novel therapeutic strategies to fine-tune antibacterial immunity during pneumonia. TBK1 (TANK-binding kinase 1) is a multifunctional kinase that is ubiquitously expressed in both hematopoietic and nonhematopoietic cells. It performs multiple functions related to innate immunity, autophagy, and energy homeostasis (2). In antimicrobial innate defense, TBK1 is best known for its role in inducing type I IFN production through phosphorylation of IRF3 (IFN-regulatory factor 3) (3). This signaling cascade is initiated after sensing of, for example, viral RNA by RIG-I (retinoic acid–inducible gene I)–like receptors or TLR3 (Toll-like receptor 3), microbial DNA by the cGAS (cyclic guanosine monophosphate–AMP synthase)–STING (stimulator of interferon genes) pathway, or LPS by TLR4. cGAS and STING are involved in innate recognition of Streptococcus pneumoniae infection (4, 5), and type I IFNs have been shown to influence antipneumococcal defense in mice (6, 7). Moreover, TBK1 was previously shown to directly phosphorylate the transcription factor STAT6 (signal transducer and activator of transcription 6), thereby regulating expression of several chemokines during viral infection (8). In addition to promoting gene expression, TBK1 can also contribute to antimicrobial defense by regulating autophagic degradation of intracellular pathogens (9). TBK1’s role in promoting autophagosome formation is dependent on its capacity to phosphorylate several molecules involved in autophagosome formation or regulation (2). Although S. pneumoniae has been shown to trigger canonical autophagy in epithelial cells (10), the role of autophagy in immune defense against pneumococci in the lung is not well understood. In this issue of the Journal, Hagan and colleagues (pp. 671–681) report on the role of TBK1 in pneumococcal pneumonia (11). This work extends previous studies in which the investigators described key factors involved in IFN-g production by neutrophils (12) and upregulation of TBK1 in neutrophils from S. pneumoniae–infected mouse lungs (13). In this new publication, the authors demonstrate reduced survival of TBK1-deficient mice upon S. pneumoniae infection compared with control animals. Moreover, systemic TBK1 knockouts, but not mice lacking TBK1 in macrophages, showed reduced proinflammatory cytokine production, a trend toward reduced type I IFN induction, and a slight defect in controlling bacterial replication (Figure 1). These data indicate that TBK1 in
Microbiological quality and safety of the Zambian fermented cereal beverage: Chibwantu

Fermentation is one of the oldest skills used for food preservation. Indigenous cereal based fermented food products are prepared in Africa using various techniques and raw materials and the food products form a vital part of the diet of many communities. The food products are highly esteemed because of their flavor and taste and the keeping quality under ambient conditions; thereby contributing to food security. Several indigenous cereal based fermented foods and beverages are prepared at household level in Zambia and the foods are consumed by members of the household including toddlers and children. The beverages include chibwantu, munkoyo, thobwa, katata, katubi, gankhata (seven days), kachasu and some commercial opaque alcoholic beverages such as chibuku. Literature on the microbiology of these foods such as the dominant microorganisms involved during fermentation, nutrition and probiotic potential is not available. Therefore, the objective of this review is to highlight some of these cereal based fermented foods prepared in Zambia with emphasis on the beverages and document the information known about them and examine some of the similar non-alcoholic beverages prepared in Africa. Since the focus of the current study is on Zambian cereal based fermented foods prepared using the munkoyo roots; which are plant products and also the fact that the beverages are sold in local markets, the antimicrobial potential of plant products as well as the spoilage and safety of cereal based fermented foods, including the street vended was examine. The documented information would be valuable in devising scientific means of improving their quality and optimizing their production.