Miracle-dz/UniFAR-FTUs huggingface dataset:
Ratio of T1-Weighted to T2-Weighted Signal Intensity as a Measure of Tissue Integrity: Comparison with Magnetization Transfer Ratio in Patients with Multiple Sclerosis

SUMMARY: The study aim was to compare the ratio of T1WI to T2WI signal intensity (T1/T2) with magnetization transfer ratio, a marker of myelin integrity, in patients with multiple sclerosis. A moderate correlation (r = 0.50, P = .034) was found between the magnetization transfer ratio and T1/T2 in normal-appearing gray matter, and a strong correlation for normal-appearing white matter (r = 0.63, P = .005) and lesions (r = 0.70, P = .001). Results suggest that besides myelin integrity, other factors may be playing a role in T1/T2 measures.
Elucidating the sustained decline in under‐three child linear growth faltering in Nepal, 1996–2016

Abstract Childhood linear growth faltering remains a major public health concern in Nepal. Nevertheless, over the past 20 years, Nepal sustained one of the most rapid reductions in the prevalence of stunting worldwide. First, our study analysed the trends in height‐for‐age z‐score (HAZ), stunting prevalence, and available nutrition‐sensitive and nutrition‐specific determinants of linear growth faltering in under‐three children across Nepal's Family Health Survey 1996 and Nepal's Demographic and Health Surveys 2001, 2006, 2011, and 2016. Second, we constructed pooled multivariable linear regression models and decomposed the contributions of our time‐variant determinants on the predicted changes in HAZ and stunting over the past two decades. Our findings indicate substantial improvements in HAZ (38.5%) and reductions in stunting (−42.6%) and severe stunting prevalence (−63.9%) in Nepalese children aged 0–35 months. We also report that the increment in HAZ, across the 1996–2016 period, was significantly associated (confounder‐adjusted p < .05) with household asset index, maternal and paternal years of education, maternal body mass index and height, basic child vaccinations, preceding birth interval, childbirth in a medical facility, and prenatal doctor visits. Furthermore, our quantitative decomposition of HAZ identified advances in utilisation of health care and related services (31.7% of predicted change), household wealth accumulation (25%), parental education (21.7%), and maternal nutrition (8.3%) as key drivers of the long‐term and sustained progress against child linear growth deficits. Our research reiterates the multifactorial nature of chronic child undernutrition and the need for coherent multisectoral nutrition‐sensitive and nutrition‐specific strategies at national scale to further improve linear growth in Nepal. [Correction added on 6 November 2020, after first online publication: in abstract, the citation year in the fourth sentence has been changed from ‘2001’ to ‘2011’. ]
Early Aspirin Discontinuation Following Acute Coronary Syndrome or Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The respective ischemic and bleeding risks of early aspirin discontinuation following an acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) remain uncertain. We performed a prospero-registered review of randomized controlled trials (RCTs) comparing a P2Y12 inhibitor-based single antiplatelet strategy following early aspirin discontinuation to a strategy of sustained dual antiplatelet therapy (DAPT) in ACS or PCI patients requiring, or not, anticoagulation for another indication (CRD42019139576). We estimated risk ratios (RR) and 95% confidence intervals (CI) using random effect models. We included nine RCTs comprising 40,621 patients. Compared to prolonged DAPT, major bleeding (2.2% vs. 2.8%; RR 0.68; 95% CI: 0.54 to 0.87; p = 0.002; I2: 63%), non-major bleeding (5.0 % vs. 6.1 %; RR: 0.66; 95% CI: 0.47 to 0.94; p = 0.02; I2: 87%) and all bleeding (7.4% vs. 9.9%; RR: 0.65; 95% CI: 0.53 to 0.79; p < 0.0001; I2: 88%) were significantly reduced with early aspirin discontinuation without significant difference for all-cause death (p = 0.60), major adverse cardiac and cerebrovascular events (MACE) (p = 0.60), myocardial infarction (MI) (p = 0.77), definite stent thrombosis (ST) (p = 0.63), and any stroke (p = 0.59). In patients on DAPT after an ACS or a PCI, early aspirin discontinuation prevents bleeding events with no significant adverse effect on the ischemic risk or mortality.
Health screening and preventative health care in refugee women: A qualitative analysis

Background: Regular health screening provides opportunities for early detection and effective treatment of disease. There is underutilisation of health services by migrants from culturally and linguistically diverse backgrounds, particularly refugees in Australia. Aim: To explore the beliefs, understandings, and use of health and healthcare screening services among African refugee women living in Australia. Design/Method: Qualitative secondary analysis. Method: Oral narratives derived from two primary qualitative datasets of Sub-Saharan women in New South Wales, Australia, underwent secondary thematic analysis. Findings: Twenty-two of the forty-two women had refugee status on migrating to Australia. Thematic findings reflection of misinformation, low health literacy, and health screening as not a priority. Conclusions: There is an urgent need to develop innovative strategies to engage refugee migrant women in health screening by provision of culturally meaningful health information. Relevance to clinical practice: Including refugee women’s suggestions for information to be provided by health services may improve attitudes towards screening and preventative health care.
Application of the severe fever with thrombocytopenia syndrome prediction score: Differentiation of febrile diseases using basic laboratory parameters

Background The prolonged manifestation of concurrent leukopenia, thrombocytopenia and normal C-reactive protein (CRP) (named as SFTS prediction score) in febrile diseases is not usual and may be used to make an initial differential diagnosis, which is a characteristic finding of severe fever with thrombocytopenia syndrome (SFTS). Methods The dynamics of SFTS prediction scores was investigated in SFTS patients. The study subjects for the comparison were febrile patients aged ≥ 16 years with SFTS scores of 2 (S2) or 3 (S3) who visited an emergency room for a 4-year study period. The dynamic distribution of S2 and S3 at presentation with regards to onset of illness, the characteristics of responsible diseases and the predictability of SFTS in both groups were described. Results In 104 patients with SFTS, the daily proportion of S2 or S3 ranged from 58.3 to 100% from day (D) 1 to D12 after the onset of illness. The S2 subtype of ‘leukopenia plus thrombocytopenia’ and S3 represented 72.7–100% of all scores. In contrast, for the 130 patients in the febrile cohort, 73.8% of evaluations were distributed between D1 and D4 after the onset of illness, and 68.8% of patients had the S2 subtype of ‘leukopenia plus normal CRP’. Upper respiratory infection was the most frequent (50.0%) cause of diseases. Pneumonia (13.8%) and urosepsis (6.2%) initially presented with either S2 with normal CRP or S3 but had poor prognosis. The presence of S2 or S3 predicted SFTS with sensitivity and specificity of 0.85 (0.42–0.99; 95% CI) and 0.98 (0.98–0.98; 95% CI), respectively. Conclusion The temporal distribution and composition of S2 or S3 were unique in several febrile diseases including SFTS, and the SFTS prediction score may be useful for differentiating febrile diseases in primary care settings of SFTS endemic areas.
Pengaruh Ukuran Kap, Opini Audit, Ukuran Perusahaan, Dan Profitabilitas Terhadap Audit Delay(studi Kasus Pada Perusahaan Go Public Yang Konsisten Terdaftar Di Indeks Lq45-bursa Efek Indonesia Tahun 2009-2013)

Laporan keuangan dapat bermanfaat dan relevan bagi penggunanya apabila laporan keuangan disampaikan secara tepat waktu. Salah satu faktor yang dapat mempengaruhi ketepatan waktu penyampaian laporan keuangan adalah lamanya waktu audit yang dilakukan oleh KAP atau audit delay. Audit delay adalah jangka waktu antara tanggal dimana periode laporan keuangan berakhir sampai dengan tanggal laporan auditor independen diterbitkan. Penelitian ini bertujuan untuk mengetahu apakah ukuran KAP, opini audit, ukuran perusahaan, dan profitabilitas baik secara parsial maupun simultan berpengaruh terhadap audit delay. Data yang digunakan dalam penelitian ini adalah data sekunder berupa laporan keuangan keuangan auditan dan laporan auditor independen, dengan teknik pengumpulan data menggunakan teknik dokumentasi. Populasi penelitian ini adalah seluruh perusahaan go public yang terdaftar di indeks LQ45-BEI selama tahun 2009-2013, dengan metode pengambilan sampel menggunakan metode purposive sampling. Jumlah sampel yang digunakan adalah 90 data sampel yang terdiri dari 18 perusahaan dengan periode 5 tahun. Metode penelitian dalam penelitian ini menggunakan analisis statistik deskriptif dan analisis regresi linier berganda dengan 4 uji asumsi klasik. Hasil penelitian menunjukkan bahwa semua variabel independen berpengaruh secara simultan terhadap audit delay, namun secara parsial hanya variabel profitabilitas yang berpengaruh positif signifikan terhadap audit delay, sedangkan variabel independen lainnya tidak berpengaruh signifikan terhadap audit delay. Kata Kunci : Audit Delay, Ukuran KAP, Opini Audit, Ukuran Perusahaan, Profitabilitas
A facile strategy for fabricating composite patch scaffold by using porcine acellular dermal matrix and gelatin for the reconstruction of abdominal wall defects

Defects of the abdominal wall continue to be a significant issue in regenerative medicine and tissue engineering. Porcine acellular dermal matrix (P-ADM) and gelatin have been widely used for fabricating engineered abdominal wall due to their good biocompatibility and integration with host tissues. In this study, we demonstrate a novel and reproducible approach of using gelatin and P-ADM powder to fabricate composite patch scaffolds by combining solvent casting and enzymatic cross-linking for the abdominal wall regeneration in rats. Different concentration ratios of gelatin and P-ADM and different shapes of engineered scaffolds are studied for various abdominal wall defects. Skeletal muscle cells and human umbilical vein endothelial cells can successfully attach to the surface of the scaffolds and maintain high viability after culturing for five days. In vivo experiments demonstrate that there are no signs of infection, intra-abdominal adhesion, and severe inflammation after two weeks, which indicate good repairability of the scaffolds. In conclusion, we propose a novel method that holds great potential for building engineered scaffolds to meet the different requirements of abdominal wall regeneration.
The Influence of Belief, Expectation, and Perception on Husband Participation in Vasectomy in Sekip Village, Lubuk Pakam Subdistrict, Deli Serdang

Population program, especially the reproductive rights and health including Family Planning,commencing 2005 has explicitly included as a new target in the MDGs. This is related to the4th This analytical survey study with crosssectional approach was conducted from January to June 2012 at Sekip Village, Lubuk Pakam Subdistrict, Deli Serdang District. The data obtained were analyzed through univariate analysis, bivariate analysis with Chi-square test, and multivariate analysis with multiple logistic regression tests. Increasing men’s participation in Family Planning and reproductive health is an appropriate step in an attempt to encourage gender equality, but the main problem we are currently facing is the low participation of men in the implementation of Family Planning and reproductive health programs. There are many factors causing the low participation of men in Family Planning program. One of them is psychological factor such as belief, expectation and perception . The result of this study showed that belief, expectation and perception had a significant influence with sig. = 0.017, 0.07 and 0,464. It is suggested to motivate the husbands living at Sekip Village, Lubuk Pakam Subdistrict, Deli Serdang District to participate in the vasectomy program. The Family Planning Field Workers are expected to help monitor and encourage the husbands who have performed vasectomy to be the motivators for the husbands who have not performed vasectomy.
Characteristics and Outcomes of Critically Ill Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Australia and New Zealand.

RATIONALE The characteristics and outcomes of patients presenting with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) requiring Intensive Care Unit (ICU) admission are poorly understood and there is sparse epidemiological data. OBJECTIVES The objectives were to describe epidemiology and outcomes of patients admitted to ICU with COPD and to evaluate whether outcomes varied over time. METHODS We studied adult ICU admissions across Australia and New Zealand between 2005 and 2017 with a diagnosis of AECOPD and used an admission diagnosis of asthma as comparator for trends over time. We measured changes in characteristics and outcomes over time using logistic regression, adjusting for illness severity using the Australian New Zealand Risk of Death (ANZROD) model. RESULTS We studied 31,991 admissions with AECOPD and 11,096 with asthma. Mean (SD) age for AECOPD patients was 68·3 (11·2) years, with 35·4% mechanically ventilated. For patients with AECOPD the proportion of deaths in ICU was 8·7% and in hospital was 15·4% of admissions, with the proportion of 69·2% discharged home and 5·6% discharged to a high level care facility. During the study period, the proportion of ICU admissions with AECOPD per 10,000 admissions decreased at an annual rate of 2·0 (95% CI 0·8 to 3·2) (p=0·009) but their admission rate per million population increased annually by 4·5 (95% CI 3·7 to 5·3) (p<0·0001). There was a linear reduction in mortality for AECOPD but not for asthma admissions (odds ratio annual decline: AECOPD 0·94 [0·93-0·95] and asthma 1·01 [0·97-1·05]; p=0·001) and an increase in AECOPD admissions discharged to home (odds ratio annual increase: 1·04 [1·03-1·05] vs. 1·01 [0·99-1·03]; p=0·01). The reduction in mortality was sustained after adjusting for illness severity. CONCLUSIONS Across Australia and New Zealand the rate of ICU admissions due to AECOPD is increasing but mortality rates are decreasing, with a corresponding increase in the home discharge rates.
Radiosensitization by Hyperthermia: The Effects of Temperature, Sequence, and Time Interval in Cervical Cell Lines

Cervical cancers are almost exclusively caused by an infection with the human papillomavirus (HPV). When patients suffering from cervical cancer have contraindications for chemoradiotherapy, radiotherapy combined with hyperthermia is a good treatment option. Radiation-induced DNA breaks can be repaired by nonhomologous end-joining (NHEJ) or homologous recombination (HR). Hyperthermia can temporarily inactivate homologous recombination. Therefore, combining radiotherapy with hyperthermia can result in the persistence of more fatal radiation-induced DNA breaks. However, there is no consensus on the optimal sequence of radiotherapy and hyperthermia and the optimal time interval between these modalities. Moreover, the temperature of hyperthermia and HPV-type may also be important in radiosensitization by hyperthermia. In this study we thoroughly investigated the impact of different temperatures (37–42 °C), and the sequence of and time interval (0 up to 4 h) between ionizing radiation and hyperthermia on HPV16+: SiHa, Caski; HPV18+: HeLa, C4I; and HPV−: C33A, HT3 cervical cancer cell lines. Our results demonstrate that a short time interval between treatments caused more unrepaired DNA damages and more cell kill, especially at higher temperatures. Although hyperthermia before ionizing radiation may result in slightly more DNA damage, the sequence between hyperthermia and ionizing radiation yielded similar effects on cell survival.
A public health approach to childhood obesity : the role of econometrics

The increasing prevalence of childhood obesity in the United Kingdom is of great interest to public health policy makers and guidance developers such as NICE, as well as the general public. In order to develop effective policies, the causes of childhood obesity need to be better understood. Analysing the Millennium Cohort Survey, this thesis uses econometric techniques to investigate the relationships between childhood obesity, family lifestyle behaviours and child health outcomes. The first empirical chapter investigates the causal effects of breastfeeding behaviours on obesity during early childhood, a topic which has been of particular interest to NICE. There is a small but statistically significant influence suggesting that breastfeeding should be one part of a wider effort to reduce obesity by influencing lifestyle, such as Change4Life. These effects appear to increase in magnitude and significance as children get older suggesting that the dynamics of lifestyle and childhood obesity should be investigated further. The second empirical chapter investigates the relationship between underlying family lifestyle and childhood obesity using a dynamic framework. Childhood obesity is one of the strongest predictors of obesity in adulthood. If lifestyle is learnt in childhood and is persistent then this could exacerbate the problem of childhood obesity. Amongst other findings, this chapter concludes that childhood weight status significantly depends on family lifestyle. The final empirical chapter extends this model and allows the effects of both family lifestyle and underlying health on childhood obesity to be investigated. Childhood weight is a significant outcome measure of underlying child health after the age of five. The results suggest that policies should target various lifestyle behaviours simultaneously by improving underlying lifestyle through education and improved understanding and enabling families to make positive changes.
The impact of caregiver coping strategies and patient level of functioning on perception of caregiver burden among caregivers of persons living with HIV/AIDS in Kenya

ABSTRACT There exists little research on caregiver burden among persons caring for family members with HIV/AIDS in Kenya. Research suggests that coping strategies affect the perception of caregiver burden and caregiver burden increases as a patient’s condition deteriorates. This study investigated the impact of coping strategies and activities of daily living on caregiver burden among Kenyans caring for family members living with HIV and AIDS. There was a statistically significant difference on two items of the Caregiver Burden Inventory based on patient’s total Activities of Daily Living (ADL) score. When ADLs were considered separately, there were no significant differences in caregiver burden by ADL scores. The combined coping scales on the Brief COPE were a significant predictor of caregiver burden. Self-blame, substance use, and behavioral disengagement were significantly related to caregiver burden. Implications for counselors, social workers, and researchers are discussed.
Application of Bone Marrow–Derived Mesenchymal Stem Cells for Muscle Healing After Contusion Injury in Mice

Background: Skeletal muscle injuries are very common in sports medicine. Conventional therapies have limited clinical efficacy. New treatment methods should be developed to allow athletes to return to play with better function. Purpose: To evaluate the in vitro differentiation potential of bone marrow–derived mesenchymal stem cells and the in vivo histologic and physiologic effects of mesenchymal stem cell therapy on muscle healing after contusion injury. Study Design: Controlled laboratory study. Methods: Bone marrow cells were flushed from both femurs of 5-week-old C57BL/6 mice to establish immortalized mesenchymal stem cell lines. A total of 36 mice aged 8 to 10 weeks were used to develop a muscle contusion model and were divided into 6 groups (6 mice/group) on the basis of the different dosages of IM2 cells to be injected (0, 1.25 × 105, and 2.5 × 105 cells with/without F-127 in 100 μL of phosphate-buffered saline). Histological analysis of muscle regeneration was performed, and the fast-twitch and tetanus strength of the muscle contractions was measured 28 days after muscle contusion injury, after injections of different doses of mesenchymal stem cells with or without the F-127 scaffold beginning 14 days after contusion injury. Results: The mesenchymal stem cell–treated muscles exhibited numerous regenerating myofibers. All the groups treated with mesenchymal stem cells (1.25 × 105 cells, 2.5 × 105 cells, 1.25 × 105 cells plus F-127, and 2.5 × 105 cells plus F-127) exhibited a significantly higher number of regenerating myofibers (mean ± SD: 111.6 ± 14.77, 133.4 ± 21.44, 221.89 ± 32.65, and 241.5 ± 25.95, respectively) as compared with the control group and the control with F-127 (69 ± 18.79 and 63.2 ± 18.98). The physiologic evaluation of fast-twitch and tetanus strength did not reveal differences between the age-matched uninjured group and the groups treated with various doses of mesenchymal stem cells 28 days after contusion. Significant differences were found between the control group and the groups treated with various doses of mesenchymal stem cells after muscle contusion. Conclusion: Mesenchymal stem cell therapy increased the number of regenerating myofibers and improved fast-twitch and tetanus muscle strength in a mouse model of muscle contusion. However, the rapid decay of transplanted mesenchymal stem cells suggests a paracrine effect of this action. Treatment with mesenchymal stem cells at various doses combined with the F-127 scaffold is a potential therapy for a muscle contusion. Clinical Relevance: Mesenchymal stem cell therapy has an effect on sports medicine because of its effects on myofiber regeneration and muscle strength after contusion injury.
The French reporting system for drug shortages: description and trends from 2012 to 2018: an observational retrospective study

Objectives The aim was to provide figures for drug shortages in France and describe their characteristics, causes and trends between 2012 and 2018. Methods Data from the national reporting system from the Agency of Medicine and Health Product Safety (ANSM) was analysed. This database contains information regarding effective and predicted shortages of major therapeutic of interest drugs (ie, drugs whose shortage would be life-threatening or representing a loss of treatment opportunity for patients with a severe disease) which are mandatory reported by marketing authorisation holders to the ANSM. Data are presented as numbers or percentages of pharmaceutical products (ie, the product name and its formulation) reported on shortage between 2012 and 2018. Results There were 3530 pharmaceutical products reported on shortage during the period, including 1833 different active substances. Drugs on shortage were mostly old products (63.4%) with national marketing authorisation procedures (62.8%), as well as injectable and oral forms (47.5% and 43.3%, respectively). Anti-infectives for systemic use ranked first (18%), followed by nervous and cardiovascular system drugs and by antineoplastic and immunomodulating agents (17.4%, 12.5% and 10.4%, respectively). The number of reported shortages presented a fourfold increase between 2012 and 2018 and a sharp rise in 2017 and 2018, along with a rise in the number of active substances on shortage. The therapeutic classes concerned remained similar over time. Manufacturing and material supply issues were the main reported reasons for the shortage each year (30%) and there was an overall rise of pharmaceutical market reasons. Conclusion Drug shortages were increasingly reported in France. Preventive measures should specifically target the products most on shortage, in particular old drugs, injectable, anti-infective, nervous system and cardiovascular system drugs as well as antineoplastic and immunomodulating agents.