Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of motor recovery with stroke in chronic state demostrated electromyography, fMRI, and DTI

The aim of this study was to evaluate the motor recoveries in 3 chronic hemiparetic patients with Fugl-Meyer assessment (FMA), modified Ashworh scale (MAS), manual muscle test (MMT) scores, EMG characteristics, cortical activation and white matter changes before and after the training program with a symmetrical upper-limb motion trainer training. The training was performed at 1 hr/day, 5 days/week during 6 weeks. Electromyographic activities of the affected hand were recorded during isometric wrist flexion/extension movements. In all patients, FMA and MMT scores except MAS were significantly improved after the 6-week training. Delay in onset/offset of muscle contraction significantly decreased in the affected wrist during the training. The cocontraction ratio of flexor/extensor muscles decreased significantly after the training. We compared cortical activations in two different tasks before and after the training program. Functional magnetic resonance imaging (fMRI) studies in unilateral wrist movement showed that cortical activations decreased in ipsilateral SMC but increased in contralateral SMC and ipsilateral cerebellum. In bilateral wrist movements, bilateral SMC, PMA, SMA and cerebellum showed cortical reorganizations. Diffusion tensor imaging (DTI) results also showed that fractional anisotropy (FA) significantly increased after the training. It seemed that the cortical reorganization was induced by the 6-week training using the symmetrical upper limb motion trainer.
Three papers on Side Effects and Modern Contraceptive Use among Women in Ghana

This thesis investigates the issue of side effects and how they may act as a barrier to the use of modern contraceptive methods among women in Ghana. Three papers are presented each addressing the issue using different sources of data and different methodologies. The disparate nature of the data sources and techniques used provides each paper with its own perspective on the research question and each paper gives a unique insight into the topic. The aim of the first paper is to use a qualitative focus group methodology to explore in-depth the way individuals perceive information about family planning. The study seeks to better define what is meant by the term fear of side effect in this particular social context and to determine on what information and from what sources is this fear constructed. Overall the findings of this study show that fear of side effects does act as a significant barrier to the use of temporary methods and these fears result mainly from a large amount of negative information regarding side effects being passed through the social network. However the events being recounted cannot be dismissed as myth or rumour as they are most often based in real experiences. The second paper uses monthly data on contraceptive use and the experience of side effects from the calendar section of a longitudinal survey of women in Southern Ghana. Using life tables and a multi-level logistic discrete-time hazards model this study analyses contraceptive discontinuation and how it relates to the concurrent self-reported experience of side effects. The results show that experiencing side effects is associated with a higher probability of discontinuation of the method and that counselling from health workers is extremely important in minimizing discontinuation rates. The third paper uses a sub-sample of women who are not current contraceptive users from the 2003 GDHS. The study uses multiple logistic regression to determine the association between exposure to family planning information, through mass media and interpersonal channels, and the probability that a respondent will cite fear of side effects as their main reason for not intending to use a contraceptive method in the future. The results show that the only family planning communication variable which does have a significant effect is receiving a message from a health worker which increases the odds of fear of side effects being the main reason for not intending to use a method in the future. Overall the socio-economic characteristics of those not intending to use a method in the future due to a fear of side effects is more similar to current users than to those who are not intending to use in the future for other reasons.
The National Survey of America?s Families: An Overview of the Health Care Component

This paper provides an overview of the health policy component of the National Survey of America? s Families (NSAF), fielded as part of the Urban Institute? s Assessing the New Federalism project. The paper is intended to provide policymakers, researchers, and potential users of public use files with an overview of NSAF? s purpose, sampling approach and questionnaire content, with a focus on issues that will be of primary interest to health care researchers. Additionally, we describe planned research using the survey and dates for public release of the NSAF data. (Inquiry 1999 Fall;36(3):353-362)
Implementation and coverage of treatment and prevention interventions for diarrhoeal diseases in Karnataka State: A data based study

Background: Children are the backbone of future nation. Among the causes for under-5 mortality and infant mortality if we exclude neonatal mortality, then diarrhoeal diseases form the second most leading cause of both infant & under5 mortality following pneumonia in developing countries. In India, during 2014, about 11.6 million cases with 1,323 deaths were reported in India. In Karnataka about 18-20% of under-5 deaths occur due to diarrhea. This is both preventable and treatable. Methods: This is an evaluation of data available from various sources like SRS, UNICEF data, DLHS and HMIS reports. The indicators which were studied are Impact indicators, Diarrhoeal prevention indicators and Diarrhoeal treatment indicators. Results: The Infant Mortality Rate observed over the years shows a declining trend. Most of the indicators like improvement in the drinking water sources, measles vaccination and population utilizing ORS treatment show an increase. It is seen that the Exclusive breastfeeding shows a decreased coverage. There is no marked increase in treatment seeking for diarrhoeal diseases. Awareness of diarrhoea is decreased from 88.4 to 74.6%. Zinc use also can be scaled up as its coverage was <50%. Conclusion: The interventions for diarrhoeal control, both treatment and preventive are effectively done at the level of home, community and as an outreach. , There is a rational mix of community & facility based measures. Lack of awareness perpetuates the need to develop more effective ways for creating awareness.
The deduced probable HLA-C*03:187-associated human leukocyte antigen haplotype (A*24:02-B*35:01-C*03:187-DRB1*11:01) revealed in Taiwanese unrelated hematopoietic bone marrow stem cell donors

Objective: HLA-C*03:187 is a rare frequency allele in the human leukocyte antigen (HLA)-C locus. The purpose of this investigation is to indicate the ethnicity of C*03:187 and its deduced plausible HLA haplotype in association in Taiwanese unrelated bone marrow stem cell donors. Materials and Methods: A DNA sequence-based typing procedure was used to verify the rare frequency allele C*03:187. Employing group-specific primer sets' polymerase chain reaction was carried out to amplify exons 2 and 3 of HLA-A locus, HLA-B locus, exon 1 to exon 7 of the HLA-C locus, and exon 2 of the HLA-DRB1 locus. The amplified gene products were sequenced employing the BigDye® Terminator Cycle Sequencing Ready Reaction kits in both directions according to the manufacturer's instructions. Results: The DNA sequence of C*03:187 is identical to C*03:03:01:01 from exon 1 to exon 7, except for codon 152 of exon 3 where GAG of C*03:03:01:01 is replaced by GTG in C*03:187. The nucleotide replacement causes one amino acid change to the protein sequence of C*03:03:01:01 at position 152 where glutamic acid (E) is changed to a valine (V) in C*03:187. The deduced plausible HLA haplotype in association with C*03:187 in Taiwanese is as A*24:02-B*35:01-C*03:187-DRB1*11:01. Conclusion: The data on the deduced plausible HLA haplotype in association with the low-frequency C*03:187 allele that we described in this report are valuable for immunogenetics laboratories for reference purposes. In addition, they can be utilized by search coordinators in hematopoietic stem cell transplant programs to determine a strategy for locating compatible donors in unrelated bone marrow donor registries for a patient with this unusual HLA allele.
Scoping review on the state of the environment reports in Ontario

Under the purview of the Ontario Public Health Standards, specifically the Environmental Health Program Standards, Boards of Health (BOHs) are required to identify and report potential public health risks, health hazards, and conditions that can affect healthy environments. BOHs often utilize State of the Environment (SOE) reports to fulfill this mandate. The purpose of SOE reports is to disseminate vital information regarding the status of environmental factors that can impact human health and their related effects. Currently, BOHs in Ontario do not use a common approach to SOE reporting. A scoping review methodology was adopted to evaluate the range of content and level of information covered within the most recent SOE reports from 14 BOHs. The scoping review provided an opportunity to catalogue common themes and information contained within each of the reports. This information was then used to create a framework that could serve as a guideline for future SOE reporting.
Circulating Tumor Cell Detection In Epithelial Ovarian Cancer Using Dual-Component Antibodies Targeting EpCAM And FRα

Purpose Circulating tumor cell (CTC) detection methods based on epithelial cell adhesion molecule (EpCAM) have low detection rates in epithelial ovarian cancer (EOC). Meanwhile, folate receptor alpha (FRα) has high expression in EOC cells. We explored the feasibility of combining FRα and EpCAM as CTC capture targets in EOC. Patients and methods EpCAM and FRα antibodies were linked to magnetic nanospheres (MNs) using the principle of carbodiimide chemistry. Blood samples from healthy donor spiked with A2780 ovarian cancer cells were used for detecting the capture rate. Ninety-five blood samples from 30 patients with EOC were used for comparing the positive rate of detection when using anti-EpCAM-MNs alone with that when using combination of anti-EpCAM-MNs and anti-FRα-MNs. Samples from 28 patients initially diagnosed with EOC and 20 patients with ovarian benign disease were used for evaluating the sensitivity and specificity of combination of anti-EpCAM-MNs and anti-FRα-MNs. Results Regression analysis between the number of recovered and that of spiked A2780 cells revealed yEpCAM = 0.535x (R2 = 0.99), yFRα = 0.901x (R2 = 0.99), and yEpCAM+FRα = 0.928x (R2 = 0.99). In mixtures of A2780 and MCF7 cells, the capture rate was 92% using the combination of anti-EpCAM-MNs and anti-FRα-MNs, exceeding the rate when using anti-EpCAM-MNs or anti-FRα-MNs alone by approximately 20% (P < 0.01). The combination of anti-EpCAM-MNs and anti-FRα-MNs showed a significantly increased positive rate of CTC detection in EOC patients compared with anti-EpCAM-MNs alone (χ2 = 14.45, P < 0.001). Sensitivity values were 0.536 and 0.75 and specificity values were 0.9 and 0.85 when using anti-EpCAM-MNs alone and when using the combination of anti-EpCAM-MNs and anti-FRα-MNs, respectively. Conclusion The combination of FRα and EpCAM is feasible as a CTC capture target of CTC detection in patients with EOC.
Clinical features, epidemiology and outcomes of infective endocarditis at a general hospital in China: A 10-year survey

This study retrospectively investigated the epidemiology, treatment and outcome of infective endocarditis (IE) in People's Liberation Army (PLA) General Hospital from 1997-2007. Totally, 65 cases were included. The results showed that bacteria were isolated from 63.08% of the IE cases. Staphylococcus was the main pathogen causing IE (43.9%), followed by Streptococcus (41.5%). Surgical treatment was performed for 81.5% (53/65) of the IE patients. The most common surgery was aortic valve replacement conducted for 58.18% of the IE patients. Six patients (9.23%) died during hospitalization. Antimicrobial agents including penicillin, vancomycin and quinolones were most frequently utilized. We concluded that early diagnosis, timely surgery and appropriate utilization of antibiotics can improve the prognosis of IE patients.
Diagnostic Nondisclosure of Schizophrenia to Chinese American Patients

If a patient is diagnosed with schizophrenia, should the mental health practitioner disclose the patient’s diagnosis? What role might culture play in influencing this decision-making process? When mental health practitioners do not tell a patient his or her diagnosis, are they being more culturally sensitive and competent or are they feeding into cultural stereotypes and misconceptions? This article examines the controversial issue of diagnostic disclosure and why practitioners may be hesitant to reveal diagnosis of schizophrenia to their Chinese American patients. The impact of the patient’s ethnic background on diagnostic disclosure or nondisclosure and practitioner biases are discussed. In addition, results from interviews with four Chinese American psychiatrists are presented as illustrative examples of the diversity of beliefs, opinions, and practices that exist among mental health professionals. Practical implications and recommendations for addressing cultural issues in relation to diagnostic disclosure are provided.
Clinicopathological Characteristics And EGFR-TKIs Efficacies In Lung Squamous Cell Carcinoma Patients Harboring An EGFR Sensitizing Mutation

Objective This study analyzed the relationship between the clinicopathological features and epidermal growth factor receptor (EGFR) mutation status of squamous cell lung cancer (SqCLC) patients. Mutation status was analyzed by comparing the amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) and next-generation sequencing (NGS). We also assessed the efficacies of EGFR tyrosine kinase inhibitors (TKIs). Methods Retrospective analysis was performed for 292 SqCLC patients treated at the Guangxi Medical University Affiliated Tumor Hospital from December 2013 to December 2018. The EGFR mutations in tumor tissues were identified by ARMS-PCR and NGS. The affiliation between EGFR mutation and clinicopathological features was analyzed. Efficacies of EGFR-TKIs and survival were evaluated using the benchmarks of response evaluation criteria in solid tumors 1.1 (RECIST 1.1) and the Kaplan–Meier method, respectively. Results Among the 292 SqCLC patients, 24 (8.2%) were identified to have an EGFR-sensitizing mutation. Both ARMS-PCR and NGS were equally effective in detecting EGFR mutations. Females and non-smokers had higher EGFR mutation rates than males and smokers (22.1% vs. 5.1%, P = 0.007 and 16.7% vs. 4.5%, P = 0.001, respectively). EGFR mutation was unrelated to the degree of differentiation, clinical stage, specimen type and level of serum carcino-embryonic antigen (CEA) and squamous cell carcinoma antigen (SCC) (P > 0.05). In the 14 EGFR mutant cases treated with EGFR-TKIs, the objective response rate (ORR) and disease control rate (DCR) were 28.6% and 78.6%, respectively. Median progression-free survival (mPFS) and overall survival (mOS) were 4.9 and 10.75 months, respectively, with fine tolerance and mild side-effects. Conclusion EGFR-sensitizing mutations are rare in SqCLC patients with females and non-smokers having a higher risk of harboring them. There was no difference in the detection rates of EGFR for both the ARMS-PCR and NGS methods. EGFR-TKIs showed modest efficacies and low toxicity profiles in EGFR mutant cases.
Race, Power, Performance and Perception: Practical and Theoretical Observations in Higher Education at the University of KwaZulu-Natal

A mixed-methods investigation of the academic performance and perceptions of a cohort of medical students was undertaken. Marks achieved in academic work were analysed in terms of eight demographic factors, including race. In addition a stratified sample of students and staff was interviewed. Statistical comparison revealed a significant difference between performance by Black and Indian students when measured in terms of race alone. However, when all eight demographic factors were analysed together, race did not independently influence performance. Racial differences were ascribed to quality of schooling. Black students experienced financial and family problems to a greater extent than other groups. Indian families set great store by education, expecting excellence. Home background was a universally important influence. A consequence of the practice of race-based admissions was revealed. Those groups selected in greater numbers displayed a wider range of academic ability and thus would tend to attain lower average marks. Minority groups were revealed as tending to excel above the majority. While the long-lasting dynamics of apartheid education explain this South African anomaly, Ogbu’s socio-historical theory supplies an alternative: ‘voluntary immigrants’ commonly interact with the educational system more positively than ‘involuntarily conquered/ enslaved’ groups. A combination of statistics, personal experiences, and insights from other unequal societies, suggests reasons behind racial disempowerment in education and its manifestation as surrogate for other inequities.
Exploiting molecular genetic diagnoses of polycystic ovary syndrome to achieve better patient outcome

Polycystic ovary syndrome (PCOS) is an endocrinopathy that affects 5% to 10% of women. It is the most common reproductive disorder in women and is characterised by menstrual irregularity, hyperandrogenism, and polycystic ovarian morphology. This disorder also involves a major risk factor for non-insulin dependent diabetes, hypertension, and cardiovascular disease. While PCOS is believed to have a complex genetic component, the exact nature of this component remains largely unknown. However, Genome Wide Association Studies (GWAS) and exome sequencing have begun to generate statistically significant and replicable data from which more specific investigations can be launched. PCOS related variants highlighted by these methods can then be the subject of functional studies that seek to identify the functional role that these variants may be involved in. The efficient uncovering of variants, including exomic identification and functional characterisation of the genetic lesions, can aid genetic diagnosis of PCOS, which in turn will help achieve better patient outcomes and provide the basis for targeted therapies. The focus of this study was that efficient genetic diagnosis of PCOS will be assisted by an increased understanding of the aetiology of PCOS gained via exome sequencing identification of related individuals and functional characterisation of variants. To this end, related individuals with clinically defined PCOS were recruited and exome sequencing carried out to uncover putative causal mutations. In addition, a functional study of growth differentiation factor-9 (GDF9) was conducted due to its role in folliculogenesis and female fertility, as well as its proximity to a PCOS linked variant (rs13164856) identified via a GWAS. A single 1-bp deletion mutation (783celC) in GDF9 was targeted, as this deletion is known to cause primary ovarian insufficiency. The possible functional role of this GDF9 variant was then tested using an in vitro model. This was achieved by creating mammalian expression vectors containing the wildtype and mutant sequences. The primary achievement of this thesis was the uncovering of causal putative mutations shared between first-degree relatives suffering from PCOS. This data will potentially aid in uncovering the aetiology of PCOS. Functional characterisation of the GDF9 mutation was unsuccessful due to failure of overexpression of the GDF9 mutant construct.
Agreement Between Reports of Parents and Children About Children’s Oral Health-Related Quality of Life

Objective: To assess agreement between reports of parents and children about children’s oral health-related quality of life (OHRQoL). Material and Methods: A total of 50 pairs of preschool-aged children, aged 5-6 years and their parents, who sought dental care at the Faculty of Dentistry of the Federal University of Amazonas, answered the Brazilian version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). SOHO-5 was completed through face-to-face independent interviews. A specific instrument containing information about demographics and socioeconomic conditions of children and their families was also applied to parents. Children’s oral examinations were performed for the diagnosis of dental caries (dmft). The agreement between total and items scores was evaluated using the means comparison and the correlation analysis, calculated by the Intraclass Correlation Coefficient (ICC). Results: There was a significant difference between the means of parent-child reports in total scores (p=0.0028) and items associated with difficulty speaking (p=0.038) and difficulty playing (p=0.0034). Children reported worse OHRQoL than their caregivers, suggesting different perceptions between them. The ICC for the total score of parent-child reports was 0.44 (95% CI, 0.02-0.68). Higher SOHO-5 scores were found in children with dental caries experience. Conclusion: Moderate agreement was observed, suggesting that the reports of parents should be complementary to those of preschool children about the OHRQoL, allowing the clinician to make the best treatment decision, according to the different views and expectations of both.
Verification of the delivered patient radiation dose for non‐coplanar beam therapy

Abstract Purpose There is an increased interest in using non‐coplanar beams for radiotherapy, including SBRT and SRS. This approach can significantly reduce doses to organs‐at‐risk, however, it requires stringent quality assurance, especially when a dynamic treatment couch is used. In this work, new functionality that allows using non‐coplanar beam arrangements in addition to conventional coplanar beams was added and validated to the previously developed in vivo dose verification system. Methods The existing program code was modified to manage the additional treatment couch parameters: angle and positions. Ten non‐coplanar test plans that use a static couch were created in the treatment planning system. Also, two plans that use a dynamic treatment couch were created and delivered using Varian Developer mode, since the treatment planning system does not support a dynamic couch. All non‐coplanar test trajectories were delivered on a simple geometric phantom, using an Edge linear accelerator (Varian Medical Systems) with the megavoltage imager deployed and acquiring megavoltage transmission images that were used to calculate the delivered 3D dose distributions in the phantom with the updated dose calculation algorithm. The reconstructed dose distributions were compared using the 3D chi‐comparison test with 2%/2mm tolerances to the corresponding reference dose distributions obtained from the treatment planning system. Results The chi‐comparison test resulted in at least a 97.0% pass rate over the entire 3D volume for all tested trajectories. For static gantry, static couch non‐coplanar fields, and non‐coplanar arcs using dynamic couch the pass rates observed were at least 98%, while for the static couch, non‐transverse coplanar arc fields, pass rates were at least 97%. Conclusions A model‐based 3D dose calculation algorithm has been extended and validated for a variety of non‐coplanar beam trajectories of different complexities. This system can potentially be applied for quality assurance of treatment delivery systems that use complex, non‐coplanar beam arrangements.