Miracle-dz/UniFAR-FTUs huggingface dataset:
Factors associated with peripheral intravenous cannulation first-time insertion success in the emergency department. A multicentre prospective cohort analysis of patient, clinician and product characteristics

Objectives This study aimed to identify the incidence of and factors associated with peripheral intravenous catheter/cannula (PIVC) first time insertion success (FTIS) in the emergency department (ED). Design Prospective cohort study. Setting Two tertiary EDs in Western Australia. Participants 879 ED patients. Primary outcome To identify factors affecting FTIS using univariate and multivariate logistic regression modelling. We created four models: patient factors only; clinician factors only; products and technology factors only and all factors model. We assessed each model’s performance using area under the receiver operating characteristic curve. Results A total of 1201 PIVCs were inserted in 879 patients. The mean age was 60.3 (SD 22) years with slightly more females (52%). The FTIS rate was 73%, with 128 (15%) requiring a second attempt and 83 (9%) requiring three or more attempts. A small percentage (3%) had no recorded number of subsequent attempts. FTIS was related to the following patient factors: age (for a 1-year increase in age: OR 0.99, 95% CI 0.983 to 0.998; p=0.0097); and target vein palpability: (always palpable vs never palpable: OR 3.53 95% CI 1.64 to 7.60; only palpable with tourniquet vs never palpable: OR 2.20, 95% CI 1.06 to 4.57; p=0.0014). Clinician factors related to FTIS include: clinicians with greater confidence (p<0.0001) and insertion experience (301–1000 vs <301: OR 1.54, 95% CI 1.02 to 2.34; >1000 vs <301: OR 2.07, 95% CI 1.41 to 3.04; p=0.0011). The final all factors model combining patient factors; clinician factors and product and technology factors has greater discriminative ability than specific factors models. It has a sensitivity of 74.26%, specificity of 57.69%, positive predictive value of 82.87% and negative predictive value of 44.85%. Conclusion A clinical decision, matching patients who have no palpable veins and are older, with clinicians with greater confidence and experience, will likely improve FTIS. Trialregistration number ANZCTRN12615000588594; Results.
Concurrent Validity of Field-Based Diagnostic Technology Monitoring Movement Velocity in Powerlifting Exercises

Supplemental Digital Content is Available in the Text. Abstract Mitter, B, Hölbling, D, Bauer, P, Stöckl, M, Baca, A, and Tschan, H. Concurrent validity of field-based diagnostic technology monitoring movement velocity in powerlifting exercises. J Strength Cond Res 35(8): 2170–2178, 2021—The study was designed to investigate the validity of different technologies used to determine movement velocity in resistance training. Twenty-four experienced powerlifters (18 male and 6 female; age, 25.1 ± 5.1 years) completed a progressive loading test in the squat, bench press, and conventional deadlift until reaching their 1 repetition maximum. Peak and mean velocity were simultaneously recorded with 4 field-based systems: GymAware (GA), FitroDyne (FD), PUSH (PU), and Beast Sensor (BS). 3D motion capturing was used to calculate specific gold standard trajectory references for each device. GA provided the most accurate output across exercises (r = 0.99–1, ES = −0.05 to 0.1). FD showed similar results for peak velocity (r = 1, standardized mean bias [ES] = −0.1 to −0.02) but considerably less validity for mean velocity (r = 0.92–0.95, ES = −0.57 to −0.29). Reasonably valid to highly valid output was provided by PU in all exercises (r = 0.91–0.97, ES = −0.5 to 0.28) and by BS in the bench press and for mean velocity in the squat (r = 0.87–0.96, ES = −0.5 to −0.06). However, BS did not reach the thresholds for reasonable validity in the deadlift and for peak velocity in the squat, mostly due to high standardized mean bias (ES = −0.78 to −0.63). In conclusion, different technologies should not be used interchangeably. Practitioners who require negligible measurement error in their assessment of movement velocity are advised to use linear position transducers over inertial sensors.
Analysis of iterative multi-user detection schemes with EXIT charts

CDMA has been established as a standard multiple access scheme in mobile radio communications. However, high spectral efficiency can only be achieved by applying multi-user detection schemes combatting the inherent multi-user interference. Since the optimum maximum likelihood approach is far too complex for practical implementations, suboptimum iterative strategies are applied. These iterative strategies follow the turbo principle well-known from coding theory and can be analyzed by means of extrinsic information transfer (EXIT) charts. This paper analyzes the performance of iterative multi-user detection schemes by EXIT charts. For simplicity, an AWGN channel and a synchronous transmission are assumed. Starting with optimum APP components, we show that the performance of the iterative scheme is well predictable by the EXIT chart technique. Results for different signal to noise ratios are presented. For non-ideal components like the parallel interference cancellation, the prediction becomes less accurate but is still possible.
Influence of residency training on the clinical reasoning development of Kenyan physiotherapists

ABSTRACT Objective: The purpose of this study was to explore the clinical reasoning development of physical therapists participating in an 18-month orthopaedic residency program in Nairobi, Kenya. Methods: A mixed methods research design was utilized. The participants’ clinical reasoning was assessed through a live patient examination prior to entering the residency program and upon graduation. One-on-one interviews were performed with the residents to explore their clinical reasoning during the final examination. Results: Residents (n = 14) demonstrated a statistically significant improvement in their ability to perform an examination of a patient and determine a hypothetical diagnosis. The clinical reasoning process described by the participants included the hypothetical deductive and narrative reasoning models. The residents did not appear to incorporate pattern recognition during the patient assessment. Discussion: Similar to studies on novice and expert practice in physical therapy, residents demonstrated an improvement in cue acquisition, the ability to verify and refute a hypothetical diagnosis, and the ability to match interventions to patients impairments. In addition, the residents utilized a combination of clinical reasoning models during the examination and evaluation of the patient including hypothetical deductive reasoning and narrative reasoning. Level of Evidence: 4
Evaluation of biophysical as well as biochemical potential of curcumin and resveratrol during prostate cancer

Abstract Purpose The present study evaluated biochemical as well as biophysical mechanisms behind the synergistic effects of curcumin and resveratrol during prostate carcinogenesis. Methods The rats were segregated into five groups that included normal control, 3,2′-dimethyl-4-aminobiphenyl (DMAB)treated, DMAB + curcumin treated, DMAB + resveratrol-treated and DMAB + curcumin + resveratrol-treated. Results The DMAB treatment resulted in a significant increase in the levels of lipid peroxidation (LPO) in DMAB treated rats. Also, significant changes were recorded in the enzyme activities of both drug metabolising enzyme and antioxidant enzymes after DMAB treatment. Further, radiorespirometric studies showed a significant increase in the 14C-glucose turnover as well as 14C-glucose uptake in the prostate slices of DMAB treated rats. Moreover, a significant rise in cell proliferation was confirmed indirectly by enhanced uptake of 3H-thymidine in the prostate slices of DMAB treated rats. Interestingly, combined treatment of curcumin and resveratrol to DMAB treated animals resulted in a significant decrease in lipid peroxidation, 14C glucose uptakes/turnover and 3H-thymidine uptake in the DMAB treated rats. Besides this, curcumin and resveratrol in combination significantly modulated biochemical indices including drug-metabolising enzymes; antioxidant enzymes in DMBA treated rats. Conclusion The study, therefore, concludes that the combination of curcumin and resveratrol holds strong modulatory potential against prostate carcinogenesis.
Distinguishing between self-control and perceived control over the environment to understand disadvantaged neighbourhood health and lifestyle outcomes

Abstract Objective: The current study aimed to test whether and how self-control and perceived control play a role in health outcomes and lifestyle differences between disadvantaged and non-disadvantaged neighbourhoods. Design: Cross-sectional survey data including demographics was collected from 3758 participants. Main outcome measures: With the survey, self-control, perceived control, health status and lifestyle variables were assessed. Results: Participants in disadvantaged neighbourhoods reported poorer general health, as well as unhealthier lifestyles compared to participants in non-disadvantaged neighbourhoods. Self-control was likewise positively associated with health and lifestyle variables. However, self-control did not differ between participants from different neighbourhoods. Perceived control over the environment mediated between type of neighbourhood and health, with participants from a disadvantaged neighbourhood reporting a lower sense of perceived control, which in turn was associated with poorer self-reported general health and less healthy lifestyle choices. Conclusion: This reveals that perceived control over one’s life and the environment is more important than self-control when explaining health differences between neighbourhoods.
Mendelian Inconsistent Signatures from 1314 Ancestrally Diverse Family Trios Distinguish Biological Variation from Sequencing Error

Abstract Next-generation sequencing enables advances in the clinical application of genomics by providing high-throughput detection of genomic variation. However, next-generation sequencing technologies, especially whole-genome sequencing (WGS), are often associated with a high false-positive rate. Trio-based WGS can contribute significantly towards improved quality control methods. Mendelian-inconsistent calls (MIC) in parent–child trios are commonly attributed to erroneous sequencing calls, as the true de novo mutation rate is extremely low compared with MIC incidence. Here, we analyzed WGS data from 1314 mother, father, and child trios across ethnically diverse populations with the goal of characterizing MIC. Genotype calls in a trio can be used to assign different signatures to MIC. MIC occur more frequently within repeats but show varying distribution and error mechanisms across repeat types. MIC are enriched within poly-A/T runs in short interspersed nuclear elements. Alignability scores, allele balance, and relative parental read depth vary among MIC signatures and these differences should be considered when designing filters for MIC reduction. MIC cluster in germline deletions and these MIC also segregate with population. Our results provide a basis for making decisions on how each MIC type should be evaluated before discarding them as errors or including them in alternative applications. With the reduction of sequencing cost, family trio whole genome and exome analysis are being performed more routinely in clinical practice. We provide a reference that can be used for annotating MIC with their frequencies in a larger population to aid in the filtering of candidate de novo mutations.
On the Security of a Privacy-Preserving Ranked Multi-Keyword Search Scheme

Ranked keyword search over encrypted cloud data is a hot research topic with huge practical implications. A complex variant of this problem is to allow searching among ciphertexts belonging to multiple data owners. Unfortunately, there exist only a few papers in the literature which address this important setting. Recently, Zhang et al. proposed a solution to this problem and claimed that their scheme provides two fundamental security requirements: ciphertext and trapdoor indistinguishability. We prove, however, that in their scheme neither the ciphertexts nor the trapdoors achieve indistinguishability. Our result shows that their scheme is insecure to be used in practice.
Mental Health Recovery Through "Art Therapy": A Pilot Study in Portuguese Acute Inpatient Setting

Abstract The main aims of the study are to a) evaluate the effectiveness of a three session program of “art therapy” on changing emotional indicators (depression, anxiety, stress, and psychological well-being) in individuals with mental illness and b) analyze the meanings attributed to creative self-expression. We performed a pre-experimental mixed approach study, with a pretest–posttest design, with twelve Portuguese male subjects, admitted to an acute psychiatry unit. The instruments used were Depression, Anxiety and Stress Scale [DASS-21]; and Ryff Scales of Psychological Well-Being [SPWB – 18] and a semi-structured interview. Comparison of the pre- and posttest indicated improvement in anxiety, stress, self-acceptance, purpose of life, and overall psychological well-being. The categories resulting from the thematic analysis of the interviews revealed the usefulness of the program in the participant recovery process. This type of psychosocial intervention in specialized clinical practice in Mental Health Nursing minimizes the disease’s impact in an organizational culture that should increasingly be oriented toward recovery.
Socialization of nurses in the Family Health Strategy: contributions to professional identity.

OBJECTIVE To verify how socialization of nurses in the Family Health Strategy (FHS) influences their professional identity. METHOD Exploratory, descriptive research, whose theoretical-methodological framework was dialectical hermeneutics, anchored in the premises of the Sociology of Professions. Data were collected through semi-structured interviews with 27 nurses from the FHS of the city of São Paulo. The resulting empirical material was subjected to Discourse Analysis. RESULTS The choice for Nursing was influenced by previous knowledge of the profession and by the affinity with care. Socialization was not limited to what was absorbed, including the search for an individual professional identity and collective sharing. FINAL CONSIDERATIONS Nursing care is built in daily practice, mobilizing the nurse for an action that includes herself, the relationship with the other and the conditions in which the work is performed, opening the opportunity for identity reconstruction, consistent with the concreteness of the work.
Effectiveness of Hammock Positioning in Reducing Pain and Improving Sleep-Wakefulness State in Preterm Infants

BACKGROUND: Hammock positioning is now frequently used with preterm infants admitted to ICUs. However, few studies have investigated the extent to which hammock positioning reduces pain and improves the sleep-wakefulness state compared with traditional positioning. METHODS: Twenty-six clinically stable newborns with gestational ages from 30 to 37 weeks who were breathing spontaneously were randomly assigned to 2 groups: a hammock-positioning group (n = 13), in which newborns were placed in hammocks in the lateral position, and a traditional-positioning group (n = 13), in which they were kept nested, also in the lateral position. The following variables were evaluated at the beginning and the end of the treatment: pain (with the Premature Infant Pain Profile, and Neonatal Facial Coding System), sleep-wakefulness state (with the Brazelton Neonatal Behavioral Assessment Scale), heart rate, breathing frequency, and peripheral SpO2. RESULTS: The subjects in the hammock-positioning group showed an improvement in pain compared with the traditional-positioning group(Premature Infant Pain Profile score, 2.62 ± 1.89 vs 2.31 ± 1.97, ΔP = .008) and sleep-wakefulness state score (2.08 ± 0.64 vs 1.23 ± 0.44, Δ P < .001), reduced heart rate (151.69 ± 5.44 vs 142.77 ± 5.18 beats/min, Δ P < .001), breathing frequency (52.31 ± 4.05 vs 50.23 ± 2.55 beats/min, Δ P = .024), and increased peripheral SpO2 (94.69 ± 2.14 vs 98.00 ± 1.22%, Δ P < .001). CONCLUSIONS: Hammock positioning was an effective treatment option to reduce pain and improve sleep-wakefulness state. It also helped to reduce heart rate and breathing frequency, and to increase peripheral SpO2, which made it a treatment option for preterm infants.
Screening for neurotoxic potential of 15 flame retardants using freshwater planarians

Asexual freshwater planarians are an attractive invertebrate model for high-throughput neurotoxicity screening, because they possess multiple quantifiable behaviors to assess distinct neuronal functions. Planarians uniquely allow direct comparisons between developing and adult animals to distinguish developmentally selective effects from general neurotoxicity. In this study, we used our automated planarian screening platform to compare the neurotoxicity of 15 flame retardants (FRs), consisting of representative phased-out brominated (BFRs) and replacement organophosphorus FRs (OPFRs). OPFRs have emerged as a proposed safer alternative to BFRs; however, limited information is available on their health effects. We found 11 of the 15 FRs (3/6 BFRs, 7/8 OPFRs, and Firemaster 550) caused adverse effects in both adult and developing planarians with similar nominal lowest-effect-levels for BFRs and OPFRs. This suggests that replacement OPFRs are comparably neurotoxic to the phased-out compounds. BFRs were primarily systemically toxic, whereas OPFRs, except Tris(2-chloroethyl) phosphate, shared a behavioral phenotype in response to noxious heat at sublethal concentrations, indicating specific neurotoxic effects. By directly comparing effects on adult and developing planarians, we further found that one BFR (3,3’,5,5’-Tetrabromobisphenol A) caused a developmental selective defect. Together, these results demonstrate that our planarian screening platform yields high content data resulting from assaying various behavioral and morphological endpoints, allowing us to distinguish selective neurotoxic effects and effects specific to the developing nervous system. Ten of these 11 bioactive FRs were previously found to be bioactive in other models, including cell culture and alternative animal models (nematodes and zebrafish). This level of concordance across different platforms emphasizes the urgent need for further evaluation of OPFRs in mammalian systems. Abbreviations DNT developmental neurotoxicity FR flame retardant BFR brominated flame retardant PBDE Polybrominated Diphenyl Ether OPFR organophosphorus flame retardant NTP National Toxicology Program DMSO dimethyl sulfoxide HTS high-throughput screening LEL lowest effect level HTTK high-throughput toxicokinetics POD point of departure
Molecular epidemiology of endemic and very virulent infectious bursal disease virus genogroups in backyard chickens in California, 2009–2017

Pathogenic strains of infectious bursal disease virus (IBDV) are associated with increased morbidity, mortality, and immunosuppression in susceptible chickens. Backyard poultry is increasing in popularity in the United States, but very little is known about the prevalence and molecular epidemiology of IBDV within these flocks. We performed a retrospective study and phylogenetic analyses of IBDV detected in backyard chickens (BYCs) submitted to the California Animal Health and Food Safety (CAHFS) diagnostic laboratory system in 2009–2017. There were 17 CAHFS autopsy cases of very virulent IBDV (vvIBDV) segment A detected by RT-rtPCR in BYC flocks from 7 counties in California from 2009–2017. During this same time period, non-vvIBDV genotypes were detected by RT-rtPCR in 16 autopsy cases originating from BYC premises in 10 counties in California. Subsequent RT-PCR and phylogenetic analysis of a segment of the hvVP2 and VP1 gene identified vvIBDV, interserotypic reassortant IBDV (vvIBDV segment A and serotype 2 segment B), and non-vvIBDV (variant/subclinical IBDV and classic IBDV) strains in BYC flocks in California.
Back massage intervention for improving health and sleep quality among intensive care unit patients.

BACKGROUND A massage may relax muscles, improve blood circulation and reduce pain and anxiety while also improving sleep quality by increasing comfort. However, there is little research on whether a back massage improves sleep quality in intensive care unit (ICU) patients. AIMS AND OBJECTIVES This study examined the effects of a back massage on improving vital signs, sleep quality, anxiety and depression among ICU patients. DESIGN Adopting a quasi-experimental design, convenience sampling was used to recruit ICU patients from a medical centre in Southern Taiwan. The experimental group received back massages for three consecutive days (n = 30), while controls received usual care (n = 30). METHODS The Verran and Snyder-Halpern Scale and the Hospital Anxiety and Depression Scale were used, and subjective and objective sleep time (wrist actigraphy and sleep duration from nurse observations) was recorded. The effect of the intervention was examined using a generalized estimating equation model with a robust standard error and an exchangeable working correlation matrix adjusting for time. RESULTS The results show that subjective sleep quality scores in ICU patients were low. Mean observed sleep time (measured by nurses) was 3·9 h, but mean sleep time measured using wrist actigraphy was 5·9 h. Back massages improved breathing in patients, increased sleep quality reflected by both subjective and objective data and were associated with a significant change in anxiety. CONCLUSIONS These findings suggest that a 10-min back massage can improve sleep quality, sleep duration, breathing and anxiety in ICU patients. RELEVANCE TO CLINICAL PRACTICE The implementation of a back massage shows positive improvements in the sleep quality of ICU patients. The training and theory of massage interventions should be further applied when developing courses in critical care nursing.
Analysis of Primary Care Computerised Medical Records with Deep Learning

The analysis of primary care data plays an important role in understanding health at an individual and population level. Currently the utilization of computerized medical records is low due to the complexities, heterogeneities and veracity associated with these data. We present a deep learning methodology that clusters 11,000 records in an unsupervised manner identifying non-linear patterns in the data. This provides a useful tool for visualization as well as identify features driving the formation of clusters. Further analysis reveal the features that differentiate sub-groups that can aid clinical decision making. Our results uncover subsets that contain the highest proportion of missing data, specifically Episode type, as well as the sources that provide the most complete data.