Miracle-dz/UniFAR-FTUs huggingface dataset:
Upper arm intermittent ischaemia reduces exercise-related increase of platelet reactivity in patients with obstructive coronary artery disease

Objective To assess whether upper arm ischaemia influences exercise-induced myocardial ischaemia and platelet activation in patients with coronary artery disease (CAD). Design Crossover study. Setting University hospital. Patients Twenty patients (17 men) of mean±SD age 64±8 years with stable CAD. Interventions Patients underwent two exercise stress tests (ESTs) on two separate days in a randomised manner: (1) a maximal EST only (EST-1); (2) a maximal EST after intermittent upper arm ischaemia (cycles of alternating 5-min inflation and 5-min deflation of a standard blood pressure cuff) (EST-2). Blood samples were obtained to evaluate platelet reactivity. Main outcome measures Platelet reactivity was assessed by flow cytometry at rest and after EST, with and without ADP stimulation, by measuring the percentage of monocyte-platelet aggregates (MPAs) and CD41 platelet expression measured as mean fluorescence intensity. Results Remote ischaemia had no significant effect on EST-induced myocardial ischaemia. At rest there were no differences before EST-1 and EST-2 in basal MPA (20.7±2.3 vs 20.8±2.4, p=0.56) and CD41 (21.5±2.3 vs 21.3±2.3, p=0.39), and ADP stimulation induced a similar increase in both MPA (+15.2±8.2% vs +14.9±8.4%, p=0.71) and CD41 (+15.7±5.7% vs 13.37±6.9%, p=0.59). While no differences in the increase in MPA and CD41 expression were observed after EST-1 and EST-2, ADP stimulation after EST-2 induced a lower increase in MPA (+18.3±8.1% vs +27.9±9.7%, p<0.001) and CD41 (+18.3±9.2% vs +27.2±12.4%, p<0.001) than after EST-1. Conclusion These results show that, in patients with stable CAD, remote ischaemia induces protection against an exercise-related increase in platelet reactivity.
Waveform contenders for 5G — OFDM vs. FBMC vs. UFMC

In this paper we review the waveform design of 4G (based on OFDM) and motivate the need for a redesign for 5G. Both the advent of the Internet of Things (IoT) and the move to user-centric processing are rendering OFDM unfeasible. With FBMC a potential contender has been promoted in recent years. Though FBMC is better suited than OFDM in theory, practical considerations pinpoint many issues of FBMC. Therefore, we have designed a new waveform called Universal Filtered Multi-Carrier (UFMC) collecting the advantages FBMC is promising while avoiding its drawbacks. In contrast to FBMC, UFMC applies a filtering functionality per sub-band instead of per subcarrier.
DIAL: a randomised trial of a telephone brief intervention for alcohol

Background Decreasing Injuries from ALcohol (DIAL) is a randomised control trial of a telephone brief intervention (BI) with injured emergency department (ED) patients with high-risk alcohol use. Here the authors examine 12-month outcomes of the intervention's effect on alcohol use, alcohol-related injuries and alcohol-related negative consequences. Methods ED research assistants recruited adult injured patients who screened positive for high-risk alcohol use and were to be discharged home. After discharge, all participants received by telephone an assessment of their alcohol use, alcohol-related injuries, and alcohol-related negative consequences and then were randomised to treatment or standard care. Treatment consisted of two telephone sessions of BI focusing on risky alcohol use. Both groups were reassessed after 12 months. Results At 12 months, 249 (89%) participants completed follow-up assessments. After using a log transformation, the difference in alcohol-related injuries between baseline and 12-month follow-up was greater in the BI group than the standard care group (p=0.04); this is an effect size of Cohen's d=0.21. No difference between groups was found when comparing change in alcohol consumption and other alcohol-related negative consequences at 12 months. Conclusions These findings suggest that a telephone BI with injured ED patients may decrease alcohol-related injuries. Identifying patients with risky alcohol use in the ED and then subsequently delivering the intervention by telephone after discharge has promise as a model for BI and deserves further study.
Measurement in Exercise Electrocardiography.

This text is the published proceedings of a symposium dedicated to Ernst Simonson, MD, held in Minneapolis, September 28 and 29, 1967. Nearly half of the conference was devoted to the technical problems of engineering in order to obtain noise-free electrocardiographic signals taken during exercise for computer analysis. While it was acknowledged that exercise electrocardiograms can be quantitated by techniques currently available to the clinician, emphasis was placed on advances in data storage and computer analysis which have provided the tools to develop and apply new criteria for the differentiation between a normal and abnormal electrocardiographic response to exercise. The great value of the computer is to reduce electrocardiographic measurement and classification error, relieve humans from tedious tasks, and improve consistency of measurement. The remainder of the text is devoted to a series of excellent presentations on the physiology of human electrocardiographic response to exercise. Different methods of stress testing
MICA Gene Deletion in 3411 DNA Samples from Five Distinct Populations in Mainland China and Lack of Association with Nasopharyngeal Carcinoma (NPC) in a Southern Chinese Han population

Deletion of major histocompatibility complex class I chain‐related genes A (MICA*Del) was investigated in 3,411 DNA samples from two southern Chinese Han populations (Hunan Han, HNH; Guangdong Han, GDH), two northern Chinese populations (Inner Mongolia Han, IMH; Inner Mongolia Mongol, IMM) and one southeastern Chinese Han population (Fujian Han, FJH) using an in‐house polymerase chain reaction‐sequence specific priming (PCR‐SSP) assay, which enables direct discrimination between heterozygote and homozygote for MICA*Del. MICA*Del showed a frequency ranging from 0.8% in FJH to 5.7% in IMM (Pcorrected < 0.05), indicating northward increase in frequency of MICA*Del in Chinese populations. In contrast to the association reported recently in a Taiwan Chinese population and a Malaysian Chinese cohort, MICA*Del distribution did not differ between 1,120 patients with nasopharyngeal carcinoma (NPC) and 1,483 normal controls in the HNH population (1.03% in NPC cases vs 1.18% in the controls, OR (95% CI) = 0.87 (0.51‐1.47), p = 0.69). Further gender‐stratified analysis also failed to disclose any male‐specific association reported in a Taiwan Chinese population. Multi‐locus typing of the 94 samples carrying MICA*Del revealed two new haplotypes, HLA‐A*11:01‐B*13:01‐MICA*Del‐MICB*009N‐DRB1*04:06 and HLA‐B*35:01‐MICA*Del‐MICB*009N‐DRB1*15:01, in addition to HLA‐B*48‐MICA*Del. Unexpectedly, two samples with MICA*Del in the HNH population were each consistently found to have two distinct MICA alleles, indicating the existence of two MICA gene copies on certain HLA haplotypes. Based on the results from a sizeable case‐control study, our data suggest that there is no association between MICA*Del and NPC in the southern Chinese Han population.
Femoral arteries energy dissipation and filtering function remain unchanged after cryopreservation procedure

The aim was to evaluate our cryopreservation method effects on the mechanical properties and filtering function of human superficial femoral arteries (SFA). SFA segments from 10 multiorgan donors were divided into two groups: fresh, tested 24–48 h after harvesting, and cryopreserved/defrosted, tested after 1 month of cryopreservation. The cooling process was carried out in three steps: 2 °C/min until −40 °C; 5 °C/min until −90 °C and finally a rapid cooling by transferring the bag to vapour phase of liquid nitrogen (−142 °C). Thawing was made in two steps, a slow warming time by exposing the bag to 20 °C during 20 min, followed by a rapid warming by immersion in a 40 °C warm bath until defrost. In a circulation mock, arterial pressure [Pressure signal (P)] and diameter [Diameter (D)] were registered at similar stretch‐frequency, P and flow levels. A compliance transfer function (D/P) was used for the on‐line assessment of the arterial wall elastic (E), viscous (η), and inertial (M) properties. To evaluate the arterial wall filter function, the arterial wall D/P frequency response was characterized, the cut‐off frequency (fc) was quantified, and the viscous energy dissipation (W) was calculated. After cryopreservation, there were not significant changes in E, η, M, W, and fc.
Validity and reliability of the Internalized Stigma of Smoking Inventory: An exploration of shame, isolation, and discrimination in smokers with mental health diagnoses.

BACKGROUND AND OBJECTIVES De-normalization of smoking as a public health strategy may create shame and isolation in vulnerable groups unable to quit. To examine the nature and impact of smoking stigma, we developed the Internalized Stigma of Smoking Inventory (ISSI), tested its validity and reliability, and explored factors that may contribute to smoking stigma. METHODS We evaluated the ISSI in a sample of smokers with mental health diagnoses (N = 956), using exploratory and confirmatory factor analysis, and assessed construct validity. RESULTS Results reduced the ISSI to eight items with three subscales: smoking self-stigma related to shame, felt stigma related to social isolation, and discrimination experiences. Discrimination was the most commonly endorsed of the three subscales. A multivariate generalized linear model predicted 21-30% of the variance in the smoking stigma subscales. Self-stigma was greatest among those intending to quit; felt stigma was highest among those experiencing stigma in other domains, namely ethnicity and mental illness-based; and smoking-related discrimination was highest among women, Caucasians, and those with more education. DISCUSSION AND CONCLUSION Smoking stigma may compound stigma experiences in other areas. Aspects of smoking stigma in the domains of shame, isolation, and discrimination were related to modeled stigma responses, particularly readiness to quit and cigarette addiction, and were found to be more salient for groups where tobacco use is least prevalent. SCIENTIFIC SIGNIFICANCE The ISSI measure is useful for quantifying smoking-related stigma in multiple domains.
Edge conditions and crash-avoidance roles: the future of traffic safety in the world of autonomous vehicles

Self-driving or highly automated vehicle (HAV) technologies, now undergoing public trials in major cities,1 are positioned to bring about transformative change to the entire transportation system. Far from being a distant innovation, retail autonomous vehicles have already been announced by various manufacturers for release as early as 2018, complementing estimates that on-road HAVs will reach market ubiquity as part of a US$7 trillion passenger economy by 2055.2 Transportation planners and policymakers are welcoming HAVs for their potential to positively impact traffic safety by fundamentally changing the interaction and relationship between drivers and vehicles, and how drivers and vehicles collect and process information from their environment. HAVs will not, however, offer safety in every possible condition. As HAV technology will have limits, manufacturers and lawmakers suggest vehicles have an operational design domain (ODD) which specifies under which conditions an autonomous driving mode can perform safely.3 ODDs may require HAVs to avoid mixed vehicle routes, inclement weather conditions or unmarked roads; in general, ODDs reflect the limits of HAV technologies. In engineering terms, these are known as ‘edge conditions’: situations that go beyond the reliable and accurate capability and limits of HAV technology. The injury prevention community must understand how these edge conditions could lead to crashes in order to formulate crash countermeasures which ultimately inform vehicle development standards and training. The Haddon Matrix, the long-established safety paradigm for injury prevention, has a rich history of helping those focused on transportation safety explicitly separate roles and responsibilities of all drivers, technologies and environmental factors involved in a crash event.4 A new framework and modification of the Haddon Matrix is needed as man–machine–environment interactions will be facilitated by technology and roles in preventing a crash event will be much more shared. While one could argue that the Haddon Matrix was …
Prevalence and predictors of substance use disorders among homeless women seeking primary care: An 11 site survey

BACKGROUND AND OBJECTIVES Homeless women have shown high rates of substance use disorders (SUD), but many studies are more than a decade old, limited in geographic location, or focus only on women living outdoors or in shelters. The purpose of this study was to obtain a more current and representative sample of homeless women and the prevalence and predictors of substance use disorders among women seeking primary care at Health Care for the Homeless clinics across the US. METHODS Eleven Health Care for the Homeless (HCH) clinics in nine states contributed proportionally to a sample of n = 780 female patients who completed a self-administered survey including demographics, housing history, health, mental health, and drug and alcohol use. RESULTS Compared to the general population of women, rates were four times higher for an alcohol use disorder, and 12 times higher for a drug use disorder. DISCUSSION AND CONCLUSIONS The findings indicate a significant need for SUD services, with an equally high need for mental health services. In addition, high rates of victimization and use of tobacco, and overall poor health status, indicate overall health disparities. SCIENTIFIC SIGNIFICANCE Addressing barriers to full integration of substance use and mental health services, such as improving screening, reimbursement, clinician training, and addressing biases about motivation of this population to engage in treatment, are necessary to improve the health of women seeking care in HCH settings. (Am J Addict 2017;26:680-688).
Adult-onset Still Disease Masqueraded as Sepsis

Abstract Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease, associated with characteristic clinical and laboratory findings, which, if interpreted incorrectly, may lead to errors in the diagnosis, delay treatment, and produce significant morbidity and mortality. We present a case illustrating how AOSD may masquerade as sepsis. Our patient is a 59-year-old woman admitted with high fever, severe arthralgias, myalgias, sore throat, evanescent maculopapular rash, leukocytosis, and elevated ferritin. On initial evaluation, sepsis was the first consideration; however, despite broad-spectrum antibiotics, the patient did not improve clinically. Finally, the diagnosis of AOSD was made based on Yamaguchi's criteria. Systemic corticosteroid treatment was started along with discontinuation of antibiotic therapy, with dramatic improvement after 3 days. Adult-onset Still disease can mimic sepsis and needs to be suspected if there is no response to antibiotics in the setting of an evanescent rash that tends to occur with fever. A discussion based on a review of the literature is presented.
Factors associated with worker slipping in limited-service restaurants

Objective Slips, trips and falls (STF) are responsible for a substantial injury burden in the global workplace. Restaurant environments are challenged by STF. This study assessed individual and work environment factors related to slipping in US limited-service restaurant workers. Methods Workers in 10 limited-service restaurants in Massachusetts were recruited to participate. Workers' occupational slip and/or fall history within the past 4 weeks was collected by multilingual written questionnaires. Age, gender, job tenure, work hours per week and work shift were also collected. Shoe type, condition and gross shoe contamination were visually assessed. Floor friction was measured and each restaurant's overall mean coefficient of friction (COF) was calculated. The logistic generalised estimating equations model was used to compute adjusted odds ratios (OR). Results Of 125 workers, 42 reported one or more slips in the past 4 weeks with two reporting a resultant fall. Results from multivariable regression showed that higher restaurant mean COF was significantly associated with a decreased risk of self-reported slipping (OR 0.59, 95% CI 0.42 to 0.82). From the highest to the lowest COF restaurant, the odds of a positive slip history increased by a factor of more than seven. Younger age, male gender, lower weekly work hours and the presence of gross contamination on worker's shoe sole were also associated with increased odds of slip history. Conclusion Published findings of an association between friction and slipping and falling in actual work environments are rare. The findings suggest that effective intervention strategies to reduce the risk of slips and falls in restaurant workers could include increasing COF and improving housekeeping practices.
Professionalisierung der Pflege – vom Hilfsberuf zur evidenzbasierten Heilkunde?

Die Diskussion um die Professionalisierung der Pflege ist durch neue gesetzliche Rahmenbedingungen, Empfehlungen von Sachverständigen und nicht zuletzt internationalen Entwicklungen neu belebt worden. Im Zentrum stehen dabei das Konzept einer Evidenzbasierten Praxis (EBP) und die Idee einer erweiterten pflegerischen Praxis (Advanced Nursing Practice: ANP) inklusive der Übernahme ärztlicher heilkundlicher Tätigkeiten.
Research Paper: A General Natural-language Text Processor for Clinical Radiology

OBJECTIVE Development of a general natural-language processor that identifies clinical information in narrative reports and maps that information into a structured representation containing clinical terms. DESIGN The natural-language processor provides three phases of processing, all of which are driven by different knowledge sources. The first phase performs the parsing. It identifies the structure of the text through use of a grammar that defines semantic patterns and a target form. The second phase, regularization, standardizes the terms in the initial target structure via a compositional mapping of multi-word phrases. The third phase, encoding, maps the terms to a controlled vocabulary. Radiology is the test domain for the processor and the target structure is a formal model for representing clinical information in that domain. MEASUREMENTS The impression sections of 230 radiology reports were encoded by the processor. Results of an automated query of the resultant database for the occurrences of four diseases were compared with the analysis of a panel of three physicians to determine recall and precision. RESULTS Without training specific to the four diseases, recall and precision of the system (combined effect of the processor and query generator) were 70% and 87%. Training of the query component increased recall to 85% without changing precision.
Australian survey of current practice and guideline use in adult cancer pain assessment and management: Perspectives of oncologists

Cancer pain continues to be undertreated in up to half of cases, despite the availability of evidence‐based guidelines. This study aimed to: (i) identify barriers and facilitators to adult cancer pain assessment and management, as perceived by Australian health professionals; (ii) establish the perceived need for new Australian guidelines and implementation strategy; (iii) identify which guidelines are used; (iv) identify barriers and facilitators to guideline use. This article focuses on the perceptions of responding oncologists.
Research Paper: Classifications in Routine Use: Lessons from ICD-9 and ICPM in Surgical Practice

OBJECTIVE Classifications of diagnoses and procedures are very important for the economical as well as the quality assessment of surgical departments. They should reflect the morbidity of the patients treated and the work done. The authors investigated the fulfillment of these requirements by ICD-9 (International Classification of Diseases: 9th Revision) and OPS-301, a German adaptation of the ICPM (International Classification of Procedures in Medicine), in clinical practice. DESIGN A retrospective study was conducted using the data warehouse of the Surgical Center II at the Medical Faculty in Essen, Germany. The sample included 28,293 operations from the departments of general surgery, neurosurgery, and trauma surgery. Distribution of cases per ICD-9 and OPS-301 codes, aggregation through the digits of the codes, and concordance between the classifications were used as measurements. Median and range were calculated as distribution parameters. The concentration of cases per code was graphed using Lorenz curves. The most frequent codes of diagnoses were compared with the most frequent codes of surgical procedures concerning their medical information. RESULTS The total number of codes used from ICD-9 and OPS-301 went up to 14 percent, depending on the surgical field. The median number of cases per code was between 2 and 4. The concentration of codes was enormous: 10 percent of the codes were used for about 70 percent of the surgical procedures. The distribution after an aggregation by digit was better with OPS-301 than with ICD-9. The views with OPS-301 and ICD-9 were quite different. CONCLUSION Statistics based on ICD-9 or OPS-301 will not properly reflect the morbidity in different surgical departments. Neither classification adequately represents the work done by surgical staff. This is because of an uneven granularity in the classifications. The results demand a replacement of the ICD-9 by an improved terminological system in surgery. The OPS-301 should be maintained and can be used at least in the medium term.
Effects of socio-psychological stress on new and recurrent low back pain among Chinese community middle-aged women

This study aims to estimate the incidence of and recurrence of LBP among Hong Kong middle-aged women; to describe the characteristics and effects of current LBP; and also to clarify the relationship between socio-psychological stress and the incidence or recurrence of LBP among Hong Kong middle-aged women. An 18-month prospective study was conducted among Hong Kong community-based middle-aged Chinese women. Data was collected by face-to-face interview. The data included status and descriptions of the occurrence of LBP, sociodemographic factors, menopausal status, and socio-psychological stress. Socio-psychological stress covered social factors, stressful life events and self-reported nature of, and stress related to, housework/work. For the rate of LBP, 18-month incidence of new and recurrent LBP was 12% and 48%, respectively. For the psychosocial risk factors, we have observed an association between increased psychological stress related to housework or work within the 18-month period and the subsequent onset of both new and recurrent episodes of LBP (i.e. adjusted relative risk (RR) = 3.33 and adjusted RR = 0.54, respectively). Our results support the need for health education regarding self-assessment and management of LBP and equipping middle-aged women on how to cope with psychosocial stress and adverse life events.