Miracle-dz/UniFAR-FTUs huggingface dataset:
Advance end-of-life healthcare planning in an acute NHS hospital setting ; development and evaluation of the Expression of Healthcare Preferences ( EHP ) document

Objective: design and evaluate a document to enable older inpatients in an NHS hospital to discuss and record end-of-life healthcare preferences. Design: user and professional collaboration to design the Expression of Healthcare Preferences (EHP). Prospective questionnaire survey and outcome evaluation. Setting and Participants: inpatients on wards for older adults in a London NHS Hospital Trust. Results: the EHP consists of a form and explanatory booklet. 95 patients (mean age 81, median MMSE 28) received the EHP. 61 (64% (54–74%)) read the EHP and 29 (48% (35–61%)) of these recorded their healthcare preferences in the EHP form. The form prompted end-of-life care discussions between 43% (30–57%) of these patients and medical staff and between 52 (38–65) of these patients and “those close to them”. The EHP was highly rated: on a score of 1 to 10 it was thought to be helpful (median score 8), interesting (8), informative (8) and reassuring (7) but not upsetting (1). Conclusion: the EHP is an end-of-life advance healthcare planning tool that we have shown can be used to prompt older inpatients to discuss and record their end-of-life healthcare preferences.
Muscle characteristics in patients with chronic systemic inflammation

Introduction: Histological characteristics of age‐related muscle wasting are type II muscle fiber atrophy, accumulation of oxidative stress‐induced lipofuscin granules and decreased satellite cell numbers. There is increasing clinical evidence for a strong correlation between chronic systemic inflammation and age‐related muscle wasting. The aim of this study was to determine the impact of chronic systemic inflammation on age‐related histological muscle characteristics. Methods: As a model for chronic systemic inflammation, we included 10 patients suffering from rheumatoid arthritis (RA) and 27 control patients suffering from osteoarthritis (OA). Biopsies were taken from the vastus medialis muscle. Results: No significant differences were found in type II muscle fiber atrophy, lipofuscin accumulation, or satellite cell number in RA compared with OA patients. Conclusions: These results suggest there is no association between chronic systemic inflammation in RA and age‐related muscle characteristics. Future research should focus on inflammation and satellite cell function. Muscle Nerve 46: 204–209, 2012
Sarcopenia: European consensus on definition and diagnosis

The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and Geriatrics—European Region and the International Association of Nutrition and Aging. These organisations endorsed the findings in the final document. The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools and cut-off points can be used? (iv) How does sarcopenia relate to cachexia, frailty and sarcopenic obesity? For the diagnosis of sarcopenia, EWGSOP recommends using the presence of both low muscle mass + low muscle function (strength or performance). EWGSOP variously applies these characteristics to further define conceptual stages as ‘presarcopenia’, ‘sarcopenia’ and ‘severe sarcopenia’. EWGSOP reviewed a wide range of tools that can be used to measure the specific variables of muscle mass, muscle strength and physical performance. Our paper summarises currently available data defining sarcopenia cut-off points by age and gender; suggests an algorithm for sarcopenia case finding in older individuals based on measurements of gait speed, grip strength and muscle mass; and presents a list of suggested primary and secondary outcome domains for research. Once an operational definition of sarcopenia is adopted and included in the mainstream of comprehensive geriatric assessment, the next steps are to define the natural course of sarcopenia and to develop and define effective treatment.
Nintedanib in Japanese patients with idiopathic pulmonary fibrosis: A subgroup analysis of the INPULSIS® randomized trials

Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive fibrosing interstitial pneumonia. Nintedanib significantly reduced the annual rate of decline in forced vital capacity (FVC) compared with placebo in patients with IPF in two replicate trials (INPULSIS®). We examined the efficacy and safety of nintedanib in Japanese patients.
Evaluating the Clinical COPD Questionnaire: A systematic review

The Clinical COPD Questionnaire (CCQ) is recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) to evaluate health status in patients with COPD. The objective of this work was to systemically assess the reliability, validity, responsiveness and minimum clinically important difference (MCID) of the CCQ. A structured search was conducted in three databases to identify articles that evaluated the psychometric properties of the CCQ in individuals with COPD. Two investigators screened the title, abstract and full text of the articles to determine study eligibility and performed the data extraction. Quality assessment of included studies was assessed by the COSMIN (Consensus‐Based Standards for the Selection of Health Measurement Instruments) checklist. Finally, 43 studies were included, over half of which had fair methodological quality. Internal consistency (reliability) of the CCQ total score ranged from 0.84 to 0.94, and test‐retest reliability was 0.70–0.99. The overall CCQ had a better correlation with St George's Respiratory Questionnaire (SGRQ; from 0.71 to 0.88) and COPD Assessment Test (CAT; from 0.64 to 0.88) than modified Medical Research Council (mMRC; from 0.392 to 0.668) and forced expiratory volume in 1 s (FEV1% predicted; from −0.31 to −0.68). Scores were different within GOLD stages, groups, composite events and co‐morbidities. CCQ was sensitive to exacerbations, pulmonary rehabilitation and smoking cessation with the MCID of 0.4. The CCQ is a very useful and practical tool that can be used in clinical populations with good reliability, validity and responsiveness to interventions.
Corticosteroids in Duchenne muscular dystrophy: Major variations in practice

Introduction: In 2004, a Cochrane Review and AAN practice parameter concluded that prednisone 0.75 mg/kg/day is of short‐term efficacy in Duchenne muscular dystrophy (DMD). Subsequent efforts to standardize care for DMD indicated wide variation in corticosteroid use. Methods: We surveyed physicians who follow patients with DMD, including: (1) clinics in the TREAT‐NMD (Translational Research in Europe—Assessment and Treatment of Neuromuscular Diseases) network (predominantly Europe) and (2) U.S. MDA clinic directors. We also documented the co‐administered corticosteroids in a trial of a putative treatment (ataluren) for DMD. Results: Of 105 Treat‐NMD clinicians, corticosteroids were not used in 10 clinics, and 29 different regimens were used—the most frequent 0.75 mg/kg/day prednisone (61 centers); 10 days on/10 days off (36 centers); 0.9 mg/kg/day deflazacort (32 centers); and 5 mg/kg/day on weekends (10 centers). Similar diversity was identified in MDA clinics and in the ataluren trial. Conclusions: Variability in corticosteroid use suggests uncertainty about risks/benefits of corticosteroid regimens for DMD. Muscle Nerve, 2013
Multicenter trial of the proficiency of smart quantitative sensation tests

Introduction: We assessed proficiency (accuracy and intra‐ and intertest reproducibility) of smart quantitative sensation tests (smart QSTs) in subjects without and with diabetic sensorimotor polyneuropathy (DSPN). Methods: Technologists from 3 medical centers using different but identical QSTs independently assessed 6 modalities of sensation of the foot (or leg) twice in patients without (n = 6) and with (n = 6) DSPN using smart computer assisted QSTs. Results: Low rates of test abnormalities were observed in health and high rates in DSPN. Very high intraclass correlations were obtained between continuous measures of QSTs and neuropathy signs, symptoms, or nerve conductions (NCs). No significant intra‐ or intertest differences were observed. Conclusions: These results provide proof of concept that smart QSTs provide accurate assessment of sensation loss without intra‐ or intertest differences useful for multicenter trials. Smart technology makes possible efficient testing of body surface area sensation loss in symmetric length‐dependent sensorimotor polyneuropathies. Muscle Nerve 49: 645–653, 2014
Reducing the barriers to the uptake of cataract surgical services in a tertiary hospital

Background: Cataract is a major cause of avoidable blindness and is responsible for about 50% of global blindness. Objective: To determine the effect of reducing barriers to the uptake of cataract surgical services at the University of Benin Teaching Hospital, Benin City, Nigeria. Study Design and Methods: A comparative retrospective study of the number of cataract surgeries performed from January 2005 to December 2008 was carried out. A joint partnership between the Ophthalmology Department, the hospital management and a non-profit, non-governmental organization (NGO) was established to tackle the barriers of awareness, access and high cost of surgery to the uptake of cataract surgery from January 2005. The Ophthalmology Department and hospital management agreed to perform cataract surgeries free for all cataract patients while the NGO provided all the consumables required. The number of cataract surgeries performed was obtained from the theatre records and the data obtained analysed for the number of surgeries done per year. Results: The total number of cataract surgeries performed as seventy five (75), one hundred and twenty nine (129), one hundred and six (106) and three hundred and eighty-three (383) for the years 2005, 2006, 2007 and 2008, respectively showing a significant increase in the year 2008. Poor awareness, the bureaucracy of the referral system and high cost of surgery were identified as barriers to the uptake of cataract surgical services at the University of Benin Teaching Hospital. Publicity through the mass media, direct presentation of patients to the eye clinic for screening and providing cataract services free to all patients were methods used to overcome these barriers. Conclusion: Cataract surgical output can be increased by concerted effort and joint partnership among stakeholders in the eye care sector by recognising and reducing the barriers to the uptake of cataract surgical services. Keywords: barriers, cataract, surgical services, tertiary hospital
Human and Nature‐Caused Hazards: The Affect Heuristic Causes Biased Decisions

People are more concerned about the negative consequences of human hazards compared with natural hazards. Results of four experiments show that the same negative outcome (e.g., number of birds killed by an oil spill) was more negatively evaluated when caused by humans than when caused by nature. Results further show that when identical risk information was provided, participants evaluated nuclear power more negatively compared with solar power. The affect associated with the hazard per se influenced the interpretation of the new information. Furthermore, the affect experienced in the situation fully mediated the evaluation of the negative outcomes of a hazard. People's reliance on the affect heuristic is a challenge for acceptance of cost‐benefit analyses because equally negative outcomes are differently evaluated depending on the cause. Symbolically significant information and the affect evoked by this information may result in biased and riskier decisions.
Evaluating the Potential for a Helicobacter pylori Drinking Water Guideline

Helicobacter pylori is a microaerophilic, gram‐negative bacterium that is linked to adverse health effects including ulcers and gastrointestinal cancers. The goal of this analysis is to develop the necessary inputs for a quantitative microbial risk assessment (QMRA) needed to develop a potential guideline for drinking water at the point of ingestion (e.g., a maximum contaminant level, or MCL) that would be protective of human health to an acceptable level of risk while considering sources of uncertainty. Using infection and gastric cancer as two discrete endpoints, and calculating dose‐response relationships from experimental data on humans and monkeys, we perform both a forward and reverse risk assessment to determine the risk from current reported surface water concentrations of H. pylori and an acceptable concentration of H. pylori at the point of ingestion. This approach represents a synthesis of available information on human exposure to H. pylori via drinking water. A lifetime risk of cancer model suggests that a MCL be set at <1 organism/L given a 5‐log removal treatment because we cannot exclude the possibility that current levels of H. pylori in environmental source waters pose a potential public health risk. Research gaps include pathogen occurrence in source and finished water, treatment removal rates, and determination of H. pylori risks from other water sources such as groundwater and recreational water.
Public Support for Policies to Reduce Risk After Hurricane Sandy

A phone survey was conducted in New Jersey in 2013 four months after the second of two major devastating tropical storms (Sandy in 2012 and Irene in 2011). The objective was to estimate public support for restricting land uses in flood zones, requiring housing to be built to resist storm waters, and otherwise increasing mitigation and resilience. Respondents who supported these mitigation and resilience policies disproportionately were concerned about global climate change, trusted climate scientists and the federal government, and were willing to contribute to a redevelopment program through taxes, bonds, and fees. They also tended to have collectivist and egalitarian worldviews. Half of the respondents supported at least four of the seven risk‐reducing policies. How their support translates into public policy remains to be seen. Lack of willingness to personally fund these policies is an obstacle.
Generic Versus Small-sided Game Training in Soccer

The aim of this study was to compare 7 weeks of soccer-specific small-sided game (SSG) and mixed generic fitness training, on selected physiological, perceptual and performance variables. Twenty-five elite youth players were randomly allocated to either a SSG (coach selected) or generic training group (GTG), in a randomised, parallel matched-group design. In addition to normal training, each group completed two fitness training sessions per week of equal duration. Players completed a V O (2 max) treadmill test, Multistage Fitness Test (MSFT), Yo-Yo Intermittent Recovery Test Level 1 (YYIRTL1), 12x20 m test of repeated-sprint ability (RSA) and 20-m sprint test pre and post training. Training heart rate, perceived training intensity and perceptual fatigue measures were recorded throughout the training period. There were no differences in training heart rate or perceptual well-being measures. However, the GTG did perceive their training to be more intense than SSG. There were no changes in either group for V O (2 max), MSFT, RSA or sprint performance. However, there were improvements in YYIRTL1 performance for both groups over time, but not between groups. The results show that both types of training are equally effective at improving pre-season YYIRTL1 performance, despite GTG being perceived to be more intense.
Application of the Hyper‐Poisson Generalized Linear Model for Analyzing Motor Vehicle Crashes

The hyper‐Poisson distribution can handle both over‐ and underdispersion, and its generalized linear model formulation allows the dispersion of the distribution to be observation‐specific and dependent on model covariates. This study's objective is to examine the potential applicability of a newly proposed generalized linear model framework for the hyper‐Poisson distribution in analyzing motor vehicle crash count data. The hyper‐Poisson generalized linear model was first fitted to intersection crash data from Toronto, characterized by overdispersion, and then to crash data from railway‐highway crossings in Korea, characterized by underdispersion. The results of this study are promising. When fitted to the Toronto data set, the goodness‐of‐fit measures indicated that the hyper‐Poisson model with a variable dispersion parameter provided a statistical fit as good as the traditional negative binomial model. The hyper‐Poisson model was also successful in handling the underdispersed data from Korea; the model performed as well as the gamma probability model and the Conway‐Maxwell‐Poisson model previously developed for the same data set. The advantages of the hyper‐Poisson model studied in this article are noteworthy. Unlike the negative binomial model, which has difficulties in handling underdispersed data, the hyper‐Poisson model can handle both over‐ and underdispersed crash data. Although not a major issue for the Conway‐Maxwell‐Poisson model, the effect of each variable on the expected mean of crashes is easily interpretable in the case of this new model.
The Miniarthrotomy Technique for Ankle Arthrodesis

Most of the ankle arthrodesis procedures performed at the authors' institution over the last 10 years have used a miniarthrotomy technique. This technique involves two 1.5 cm incisions, one anteromedial and one anterolateral, through which the ankle joint is visualized. Debridement of cartilage and synovium, as well as subchondral bone resection, is performed using curettes, rongeurs, and flexible chisels. The ankle is ideally positioned in the neutral position in the sagittal plane, with minimal valgus (up to 5°) and external rotation of 5° to 10°. The arthrodesis is secured with three 6.5-mm cannulated screws inserted percutaneously. The success rate of this technique has been extremely favorable when compared with the success rates reported in the literature for more extensive methods of arthrodesis. The advantages of the miniarthrotomy technique are decreased soft tissue and periosteal dissection, technical ease as compared with more demanding methods, and rapid healing time comparable to that reported for other ankle arthrodeses.
Assessing Major Accident Risks to Support Land‐Use Planning Using a Severity‐Vulnerability Combination Method: A Case Study in Dagushan Peninsula, China

Major accident risks posed by chemical hazards have raised major social concerns in today's China. Land‐use planning has been adopted by many countries as one of the essential elements for accident prevention. This article aims at proposing a method to assess major accident risks to support land‐use planning in the vicinity of chemical installations. This method is based on the definition of risk by the Accidental Risk Assessment Methodology for IndustrieS (ARAMIS) project and it is an expansion application of severity and vulnerability assessment tools. The severity and vulnerability indexes from the ARAMIS methodology are employed to assess both the severity and vulnerability levels, respectively. A risk matrix is devised to support risk ranking and compatibility checking. The method consists of four main steps and is presented in geographical information‐system‐based maps. As an illustration, the proposed method is applied in Dagushan Peninsula, China. The case study indicated that the method could not only aid risk regulations on existing land‐use planning, but also support future land‐use planning by offering alternatives or influencing the plans at the development stage, and thus further enhance the roles and influence of land‐use planning in the accident prevention activities in China.
Migration status and self-reported health among high school students in Stockholm: A cross-sectional study

This article aims to determine the self-reported health status of Swedish high school students with respect to gender and immigrant background. The sample was randomly selected from high school students aged 15–19, and 446 students participated in this study. The Nottingham Health Profile (NHP) was used for capturing health status. The results showed that the most common problem was related to energy level (23%) and the least to physical mobility (1%). The proportion for other domains ranged from 2% to 14%. Self-reported health problems were more common among immigrants than native Swedes. Female students reported more problems on all aspects of health than males. Female gender and first-generation immigrants were found to be important factors associated with feelings of ill health among the target population. Gender disparity was more important among the students with an immigrant background.
On the Number of Hamiltonian Cycles in Bipartite Graphs

We prove that a bipartite uniquely Hamiltonian graph has a vertex of degree 2 in each color class. As consequences, every bipartite Hamiltonian graph of minimum degree d has at least 21−dd! Hamiltonian cycles, and every bipartite Hamiltonian graph of minimum degree at least 4 and girth g has at least (3/2)g/8 Hamiltonian cycles. We indicate how the existence of more than one Hamiltonian cycle may lead to a general reduction method for Hamiltonian graphs.
Impact of myasthenia gravis on family planning: How do women with myasthenia gravis decide and why?

Introduction: We analyzed the impact of myasthenia gravis (MG) on decision‐making in family planning by women with the disease. Methods: In a cross‐sectional, anonymous survey, a standardized questionnaire was sent or handed out to 1,637 women with MG. Results: In total, 801 questionnaires were eligible for analysis. Over fifty percent of the patients had abstained from having children due to MG. The concern mentioned most often was the possible influence of MG medication on the unborn child (87.1%). Spouses/partners (91.8%) and MG treating physicians (82.9%) were the most important persons involved in the decision‐making process. Higher age and personal experience of intensive‐care treatment for MG were independently associated with the decision to abstain from having children. Lower level of knowledge was independently associated with the probability of discouraging other MG patients from having children. Conclusions: Women with MG need specific guidance about family planning issues, which may lead to lower rates of voluntary childlessness. On the basis of our data, more specific hypotheses can be generated that require prospective investigation. Muscle Nerve 52:371–379, 2015