Miracle-dz/UniFAR-FTUs huggingface dataset:
Calculation of number needed to treat.

To the Editor: The number of patients who would need to be treated to prevent a given adverse outcome in one patient, called the number needed to treat, is often used in randomized trials and observational studies to provide a simple measure of the effect of a treatment. The computation of the number needed to treat can, however, be inaccurate and its interpretation misleading in trials with varying follow-up times. In this case, the cumulative incidence of an outcome cannot simply be calculated as a proportion of subjects but must instead be estimated over time by means of the Kaplan–Meier .
Formal services utilization by family caregivers of persons with Dementia living in rural Southeastern U.S.A.

This paper examined the service utilization by family caregivers of dementia relatives in rural Alabama. a southeastern state in the U.S. Data were collected from a probability sample of 141 caregivers living in 45 rural counties of the state. The average number of formal services used was low. The most frequently used services were visiting nurses (38.3%), home health aids (32.6%), and homemakers (24.8%). A modified stress coping model was used to predict the six most frequently used services and the overall number of services used. The dementia severity of care recipients was related to the use of home health aids, visiting nurses, case management, and home delivered meals. Caregiver physical and emotional health predicted the use of psychological/counseling seryices. Caregiver employment status, age, and education level were related to the use of homemakers and use of delivered meals. Practice imolications for rural social workers are discussed.
Rapid-test sensitivity for novel swine-origin influenza A (H1N1) virus in humans.

To the Editor: The Naval Health Research Center serves as the Navy hub for the Department of Defense's Global Emerging Infections Surveillance and Response System (GEIS), in which it monitors influenza-like illness among recruit trainees of all military services, military dependents, and crew members of large Navy ships (population, >1000). The center works in collaboration with the Border Infectious Disease Surveillance Project of the Centers for Disease Control and Prevention (CDC), which monitors populations located on the border between California and Mexico. The first two human cases of novel swine-origin influenza A (H1N1) virus (S-OIV), known as swine flu, in .
The Process of Change in Patterns of Daily Occupations among Parents of Children with Obesity - Time use, family characteristics and factors related to change

This thesis provides new insights into parents’ patterns of daily occupations. It proceeds from the basis of an occupational perspective on family life, using an occupational lens to understand how, when and where individuals spend their time. In recent decades, lifestyles have changed worldwide and the transition into an increasingly sedentary lifestyles is a major health concern, the origins which can be traced to childhood. The overall aim of this thesis was to explore the shared patterns of daily occupations among parents of preschool-age children with obesity, and to investigate whether it was possible for parents to change the amount of time they spent with their children and the parents’ occupational value over the course of a one-year intervention. Factors related to any change in the parents’ time use as well as any change in the children’s BMI z-score, were also investigated. The first study had a qualitative approach. This study investigated the usefulness of the time-geographical diary method in facilitating reflections on how patterns of daily occupations occur and change over time. The diary method enabled the participants to reflect on and become aware of changes relevant to explaining their reasons for engaging in daily occupations in the way that they did. The second study had a quasi-experimental design in the context of a one-year intervention within the framework of an RCT and consisted of three papers. In Paper II, daily occupations among parents of children with obesity were investigated. Four main family types were identified, the shared patterns of daily occupations differed between each type in terms of the division of household work, paid work and the amount of time spent together as a family. In Paper III an increase over time was seen in the time parents spent together with their children and the parents’ perceived occupational value, along with a subsequent decrease in the children’s BMI. In Paper IV, factors associated with changes in the parents’ time use during the intervention turned out to be the parents’ finances and satisfaction with everyday occupations as well as the parents’ BMI and low sense of control at inclusion. The fathers’ perceptions of occupational values, education and their subjective health, and the mothers’ high sense of control and subjective health explained 67% of the variance in the children’s change in BMI. The findings may lead to a greater understanding of how parents shared patterns of daily occupations are shaped within the family. Together with the contributing factors for predicting change, this should be addressed in the context of the family in order to create further knowledge regarding the development of family-based interventions with an aim of child health promotion.
The cataract service satisfaction tool

Purpose – Client satisfaction is an important outcome measure of healthcare services. The aims of the present work are to develop a tool to assess client satisfaction with the components of streamlined cataract services and to conduct a pilot study to evaluate its reliability and validity.Design/methodology/approach – A validated patient satisfaction questionnaire was modified for use in a cataract service and validated by expert panel and patient focus group approach. Two versions were used to evaluate pre‐operative assessment clinic and day surgical unit. The questionnaires comprised items covering individual domains of client satisfaction plus one global satisfaction item. Together with a visual analogue scale (VAS) the questionnaires were administered to 200 consecutive cataract patients.Findings – The questionnaires were returned by 165 patients (82.5 per cent). Median individual item and global scores in the pre‐operative group were 87 and 100 per cent, respectively. In the day‐of‐surgery group medi.
Long-term mortality in patients with atrial septal defect: a nationwide cohort-study

Abstract Aims In this nationwide cohort of atrial septal defect (ASD) patients, the largest to date, we report the longest follow-up time with and without closure in childhood and adulthood compared with a general population cohort. Methods and results Using population-based registries, we included Danish individuals born before 1994 who received an ASD diagnosis between 1959 and 2013. All diagnoses were subsequently validated (n = 2277). Using the Kaplan–Meier estimates and Cox proportional hazards regression adjusted for sex, birth year, and a modified Charlson Comorbidity Index, we compared the mortality of ASD patients with that of a birth year and sex matched general population cohort. The median follow-up from ASD diagnosis was 18.1 years (range 1–53 years). Patients with ASD had a higher mortality [adjusted hazard ratio (HR): 1.7; 95% confidence interval (CI): 1.5–1.9] compared with the general population cohort. The adjusted HR 30 days after closure was 1.4 (95% CI: 1.2–1.7), and it was 2.4 (95% CI: 2.0–2.9) for patients without closure. Conclusion Overall, ASD patients had a higher long-term mortality than a general population cohort matched on birth year and gender. Our data indicate a lower relative mortality of those ASD patients undergoing closure than the ASD patients not undergoing closure.
Association between severe retinopathy of prematurity and nonvisual disabilities at age 5 years.

Severe retinopathy of prematurity is a serious complication of neonatal intensive care for preterm infants.1,2 Before effective screening and treatment became available, approximately 5% of infants with birth weights of 1250 g or less had visual acuity of 20/200 or worse at 5.5 years.3 In such children, the severity of retinopathy was a predictor of functional disability in multiple domains.1 Although the incidence of severe retinopathy has increased since the late 1980s,4 blindness caused by retinopathy has become rare in developed countries.5 Consequently, clinicians and parents may conclude that severe retinopathy is no longer associated with childhood impairments. We investigated whether infants with severe retinopathy who were diagnosed and treated under modern protocols retain an increased risk of nonvisual disabilities compared with those without severe retinopathy.
Sildenafil Increases Muscle Protein Synthesis and Reduces Muscle Fatigue

Reductions in skeletal muscle function occur during the course of healthy aging as well as with bed rest or diverse diseases such as cancer, muscular dystrophy, and heart failure. However, there are no accepted pharmacologic therapies to improve impaired skeletal muscle function. Nitric oxide may influence skeletal muscle function through effects on excitation‐contraction coupling, myofibrillar function, perfusion, and metabolism. Here we show that augmentation of nitric oxide‐cyclic guanosine monophosphate signaling by short‐term daily administration of the phosphodiesterase 5 inhibitor sildenafil increases protein synthesis, alters protein expression and nitrosylation, and reduces fatigue in human skeletal muscle. These findings suggest that phosphodiesterase 5 inhibitors represent viable pharmacologic interventions to improve muscle function.
One-year follow-up of intracoronary stem cell delivery on left ventricular function following ST-elevation myocardial infarction.

The Timing In Myocardial Infarction Evaluation (TIME)1 trial assessed whether the timing of stem cell delivery affects the recovery of left-ventricular (LV) function following myocardial infarction. Patients with anterior ST-elevation myocardial infarction (STEMI) who were reperfused with primary percutaneous coronary intervention and stenting and had at least moderate LV dysfunction. (left-ventricular ejection fraction [LVEF] ≤ 45%) were randomized (2:1) to 150 million autologous bone marrow mononuclear cells (BMCs) or placebo with intracoronary delivery performed on Day 3 (n=67) or Day 7 (n=53). At 6 months, no benefit of cell therapy was observed compared to placebo following cell delivery on Day 3 or Day 7. We now report outcomes at 1 year; the collection of clinical endpoint and cardiac magnetic resonance imaging (MRI) data was pre-specified but not the analysis plan.
A Model for Developing, Evaluating, and Disseminating Best Practices in Education and Training

With the shift toward team‐based translational science came recognition that existing strategies for training individual investigators and retaining them in the biomedical workforce would be inadequate. To support this shift, it is important to: develop innovative strategies to educate and train diverse members of research teams; evaluate those programs; and disseminate best practices broadly. We have developed a four‐phase model to facilitate the development, evaluation, and widespread dissemination of innovative strategies to train the biomedical research workforce. Phase I (Innovate) involves small scale trials of programs to address perceived training needs or new methods of delivery. Phase II (Incubate) refines and evaluates promising Phase I activities on a larger scale. Phase III (Translate) seeks to replicate initial successes either locally (Phase IIIa) or with other interested institutions (Phase IIIb). Phase IV (Disseminate) assesses whether identified local best practices can have success on a broader scale. We present specific examples from our own experience that demonstrate the utility of this model, and then conclude with opportunities and challenges related to the education and training of this workforce.
Case Study: Community Engagement and Clinical Trial Success: Outreach to African American Women

This brief report examines how the use of community engagement principles and approaches enhanced clinical trial recruitment and retention. The Community‐Engaged Research Core (CERC), a CTSA‐supported resource designed to facilitate community involvement in clinical and translational research, was consulted to provide assistance with the implementation of the clinical trial, and specifically to enhance participation of the target population—African American women. CERC's key recommendations included: (1) convene a Community Engagement Studio, (2) redesign the recruitment advertisement, (3) simplify the language used to explain the scope of the study, and (4) provide transportation for participants. As a result of these interventions, a comprehensive strategy to recruit, enroll, and retain participants was formulated. After implementation of the plan by the study team, enrollment increased 78% and recruitment goals were met 16 months ahead of schedule. Participant retention and study drug adherence was 100%. We conclude that community engagement is essential to the development of an effective multifaceted plan to improve recruitment of underrepresented groups in clinical trials.
Allergic Rhinitis and Its Impact on Sleep

Allergic rhinitis affects a fifth of the population in industrialised countries and sleep disturbance has emerged as one of the major impacts of allergic rhinitis on patients. Sleep disturbances and its consequences on daytime sleepiness and fatigue affects the health related quality of life negatively and contributes significantly to patients’suffering and major health economic costs. Experimental studies have shown that sleep disturbances are induced when the nose is blocked with adhesive tape or petroleum jelly during sleep in healthy individuals. Nasal obstruction is the most commonly reported symptom by patients with allergic rhinitis and it causes an increased number of microarousals (short awakenings). Nasal obstruction is believed to be the most important mechanism behind poor sleep and daytime sleepiness in allergic rhinitis. Relieving nasal obstruction with nasal steroids significantly improves subjective sleep compared to placebo. Allergic rhinitis is present in a majority of patients with asthma. Identifying and treating allergic rhinitis improves sleep and the health related quality of life which reduces patient suffering and potentially saves significant health economic health costs. The present chapter reviews the current literature of allergic rhinitis and its impact on sleep and the health related quality of life.
Pseudoaneurysm of arteria profunda femoris following the surgery of proksimal femur fracture: a case report

Abstract Pseudoaneurysm of arteria profunda femoris after the hip fracture is a very rare complication. The mechanism of pseudoaneursym formation may be traumatic, iatrogenic or infective injury to the arterial wall. Pseudoaneurysms of arteria profunda femoris usually give late symtomps such as persistent hip pain, thigh swelling, presence of a pulsatile mass and unexplained anemia that may suggest the diagnosis. Surgical repair, transcatheter embolization, thrombin injection under duplex imaging guidance is the treatment options for pseudoaneurysm. Angiography is a well known technique for accurate diagnosis and may be the first choice for the minimal invasive treatment. We present a case of a pseudoaneurysm of arteria profunda femoris following osteosynthesis of a proksimal femur fracture. Pseudoaneurysm was successfully treated by percutaneous placement of embolization coils. Keywords: Aneurysm, false, femoral fractures, embolization, therapeutic, angiography Ozet Kalca kiriklari sonrasinda derin femoral arterde psodoanevrizma gelismesi cok nadir gorulen bir komplikasyondur. Psodoanevrizma arter duvarinin travmatik, iatrojenik ya da enfektif bir yaralanmasina bagli olarak gelisebilir. Derin femoral arterde gelisen psodoanevrizmalar genellikle gec bulgu verirler. Bu bulgular israrli kalca agrisi, uylukta sislik, pulsatil kitle varligi ve sebebi ortaya konamayan anemi seklinde olabilir. Tedavi secenekleri arasinda cerrahi yontemler, embolizasyon, thrombin enjeksiyonu sayilabilir. Anjiografi hem teshis hem de ayni seansta tedavi imkanini saglayabilen etkili bir yontemdir. Proksimal femur kirigi cerrahi tedavisi sonrasi derin femoral arterde psodoanevrizma gelisen ve anjiografik yontemlerle perkutan embolizasyon uygulanarak tedavi edilen bir olguyu sunuyoruz. Anahtar sozcukler: Psodoanevrizma, femur kiriklari, embolizasyon, anjiografi
Susceptibility of low-density lipoprotein particles to aggregate depends on particle lipidome, is modifiable, and associates with future cardiovascular deaths

Abstract Aims Low-density lipoprotein (LDL) particles cause atherosclerotic cardiovascular disease (ASCVD) through their retention, modification, and accumulation within the arterial intima. High plasma concentrations of LDL drive this disease, but LDL quality may also contribute. Here, we focused on the intrinsic propensity of LDL to aggregate upon modification. We examined whether inter-individual differences in this quality are linked with LDL lipid composition and coronary artery disease (CAD) death, and basic mechanisms for plaque growth and destabilization. Methods and results We developed a novel, reproducible method to assess the susceptibility of LDL particles to aggregate during lipolysis induced ex vivo by human recombinant secretory sphingomyelinase. Among patients with an established CAD, we found that the presence of aggregation-prone LDL was predictive of future cardiovascular deaths, independently of conventional risk factors. Aggregation-prone LDL contained more sphingolipids and less phosphatidylcholines than did aggregation-resistant LDL. Three interventions in animal models to rationally alter LDL composition lowered its susceptibility to aggregate and slowed atherosclerosis. Similar compositional changes induced in humans by PCSK9 inhibition or healthy diet also lowered LDL aggregation susceptibility. Aggregated LDL in vitro activated macrophages and T cells, two key cell types involved in plaque progression and rupture. Conclusion Our results identify the susceptibility of LDL to aggregate as a novel measurable and modifiable factor in the progression of human ASCVD.
Complex Care Management to Decrease Emergency Department Utilization: A Case Study of the Homeless Patient Aligned Care Team Demonstration Project at VA Greater Los Angeles Healthcare System

This quality improvement (QI) dissertation is a case study of the homeless-oriented Patient Centered Medical Home demonstration program, referred to as the Homeless Patient Aligned Care Team (HPACT) at West Los Angeles VA Medical Center (WLA). The WLA HPACT program was implemented to address the complex needs of the homeless and at-risk for homelessness population using the Patient Centered Medical Home model (PCMH) - a multi-disciplinary, team-based approach to primary care. Unlike traditional PCMH models, the WLA HPACT demonstration program employed a series of complex care management interventions to tailor care for homeless Veteran patients. The primary goal of the WLA HPACT demonstration program was to decrease the number of emergency department (ED) visits among patients assigned to the WLA HPACT team by identifying tools and processes to perform complex care management for the WLA HPACT panel of patients. This dissertation identifies barriers and best practices to address needs of WLA HPACT patients to support the demonstration program's goal of decreasing their ED utilization.Tis problem-solving QI dissertation was carried out in three phases - literature review, diagnosis, and implementation. In the first phase, we conducted a literature review of the factors contributing to homeless Veteran ED utilization patterns. In the diagnosis phase, we undertook a local needs assessment (conducted by informal stakeholder focus groups) to determine the organizational context for the WLA HPACT program and how to best evaluate HPACT's objective to reduce ED utilization rates for HPACT patients. The implementation phase of this QI dissertation employed a mixed-method progress-focused formative evaluation to examine patient characteristics, intervention processes, ED utilization patterns, staff perceptions on perceived barriers and interventions to address gaps in care to decrease ED visits for current HPACT patients. The evaluation used qualitative key informant interviews and quantitative descriptive data analysis. The findings of this early implementation QI project inform clinical and organization processes for the WLA HPACT demonstration program that should be considered for on-going implementation. Recommendations for future implementation include complex care management interventions for patients with pain needs, substance abuse conditions, as well as modifications to organizational features of the program such as hours of operations, and team composition.
Best Practices in Online Teaching

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