Miracle-dz/UniFAR-FTUs huggingface dataset:
A qualitative evaluation of an interprofessional learning project

The study described in this paper focuses on an interprofessional learning (IPL) in practice project. The project entailed appointing a number of IPL in practice facilitators whose task it was to assist clinical teams to develop opportunities for students to engage in IPL. The evaluation described focuses on one of the initial project sites, a rehabilitation ward in a community hospital. The evaluation aimed to establish a range of differing perspectives on the project including service users, steering group members, the clinical team and participating students. Narrative data were collected using focus groups, one-to-one interviews, documentary analysis and postal and electronic questionnaires. Triangulation approaches were used to analyse data and the findings were largely positive. Lessons learnt included such things as practical difficulties of introducing IPL in practice, effective use of lay persons in professional education and the difficulties of engaging medical staff in such initiatives. Limitations of the study include difficulties in getting students to participate in either focus group discussions or one-to-one interviews; therefore, alternative data sources had to be deployed, such as e-mail contact. Conclusions are that even when an experienced IPL facilitator is in post there is a need to foster practice staffs’ commitment to IPL.
Topical Application of Tacrolimus Ointment Did Not Alter the Cutaneous Pigmentation of Yucatan Micropigs

Tacrolimus is a potent immunosuppressant marketed for the prevention of rejection in liver and kidney transplantation. Topical tacrolimus has been shown to be effective in the treatment of atopic dermatitis, a disease with an immunologic basis, and is currently being developed for this indication. The objective of the current study was to determine whether repeated topical application of tacrolimus ointment could result in hypopigmentation at the application site(s). Each of 10 Yucatan miniature pigs received topical application of 0.03%, 0.1%, and 0.3% tacrolimus ointment, positive control (a combination of 2% 4-hydroxyanisole and 0.01% all-trans-retinoic acid, 4-HAArRA), and a negative control (vehicle placebo) to five test sites (approximately 12.5 cm2) along either side of the dorsal midline (10 sites per animal). Tacrolimus and controls were randomly assigned to the test site on each animal and were applied unoccluded twice daily for 8 weeks at a dose volume of 0.1 ml per site for tacrolimus and vehicle control and 0.025 ml per site for the positive control. Topical application of tacrolimus ointment in concentrations of up to 0.3% for 8 weeks had no effect on the cutaneous pigmentation of Yucatan miniature swine. In contrast, the application of 4-HAArRA produced a statistically significant (P<.05) induction of hypopigmentation from week 4 through the end of the study application.
Busulfan 12 mg/kg plus melphalan 140 mg/m2 versus melphalan 200 mg/m2 as conditioning regimens for autologous transplantation in newly diagnosed multiple myeloma patients included in the PETHEMA/GEM2000 study

Background The aim of this study was to compare the long-term safety and efficacy of oral busulfan 12 mg/kg plus melphalan 140 mg/m2 and melphalan 200 mg/m2 as conditioning regimens for autologous stem cell transplantation in newly diagnosed patients with multiple myeloma in the GEM2000 study. Design and Methods The first 225 patients received oral busulfan 12 mg/kg plus melphalan 140 mg/m2; because of a high frequency of veno-occlusive disease, the protocol was amended and a further 542 patients received melphalan 200 mg/m2. Results Engraftment and hospitalization times were similar in both groups. Oral busulfan 12 mg/kg plus melphalan 140 mg/m2 resulted in higher transplant-related mortality (8.4% versus 3.5%; P=0.002) due to the increased frequency of veno-occlusive disease in this group. Response rates were similar in both arms. With respective median follow-ups of 72 and 47 months, the median progression-free survival was significantly longer with busulfan plus melphalan (41 versus 31 months; P=0.009), although survival was similar to that in the melphalan 200 mg/m2 group. However, access to novel agents as salvage therapy after relapse/progression was significantly lower for patients receiving busulfan plus melphalan (43%) than for those receiving melphalan 200 mg/m2 (58%; P=0.01). Conclusions Conditioning with oral busulfan 12 mg/kg plus melphalan 140 mg/m2 was associated with longer progression-free survival but equivalent survival to that achieved with melphalan 200 mg/m2 but this should be counterbalanced against the higher frequency of veno-occlusive disease-related deaths. This latter fact together with the limited access to novel salvage therapies in patients conditioned with oral busulfan 12 mg/kg plus melphalan 140 mg/m2 may explain the absence of a survival difference. Oral busulfan was used in the present study; use of the intravenous formulation may reduce toxicity and result in greater efficacy, and warrants further investigation in myeloma patients. (Clinicaltrials.gov identifier: NCT00560053).
Analysis of factors related to complaints in medical schemes

Medical schemes are insurance institutions that cover medical expenses in South Africa. These institutions reimburse their members for actual expenditure on health. The Medical Schemes Act (Act 131 of 1998) defines the business of a medical scheme as the business of undertaking liability in return for a contribution in order to make provision for obtaining any relevant health service. The Council for Medical Schemes (CMS) is an autonomous statutory body created by parliament to regulate the medical schemes industry in South Africa. The CMS handles complaints from members of medical schemes. The objective of the study was to assess factors that impact on the response time to complaints by members of medical schemes. Survival analysis techniques were employed to assess these factors. The regression models controlled for factors such as, medical scheme type, medical scheme size, severity of complaints and effects of the analysts. The model revealed the effect of analysts as a significant factor to response time to complaints. The findings of the study revealed useful results in terms of identifying analysts that take longer to resolve complaints. The study also revealed that the nature of complaints as an important factor to the response time. There is a need for the complaints department to be properly resourced and continuously train staff to ensure effective resolution of complaints in medical schemes. Key words: Survival analysis, Kaplan-Meier, Tarone-Ware test, Cox proportional hazard model, log-rank test.
Using the DIAL-F Systems Model as the Conceptual Framework for an Audit of In-Patient Falls Risk Management

Most interventions for managing (reducing) the risks associated with in-patient falls have used a clinical approach to address underlying frailty and illness (physical and mental) with drugs, technology and therapy. This paper reports the results of a two stage audit on in-patient falls risk management at two teaching hospitals in the UK in July 2013 using the DIAL-F systems model as a Human Factors/Ergonomics (HFE) conceptual framework to explore patient engagement with falls risk management. Some safety critical system misalignments were found, and it is suggested that a future HFE intervention might include addressing the problems of (1) reach distances to walking aids and (2) obstacles in the bedside area for patients needing mobility assistance.
Effect of A Kappa-opioid Receptor Agonist U50488H Given at Early Reperfusion Phase in Isolated Rat Hearts

The experiment was performed to determine the role of κ-opioid receptor (OR) agonist U50488H given at early reperfusion. Methods:Isolated hearts were subjected to 30 minutes of regional ischemia and 120 minutes of reperfusion.Hearts were assigned randomly to one of the three groups:1) Control (n = 9), 2) U50-1 (n = 8); 1μM of U50488H, and 3) U50-10 (n = 8); 10μM of U50488H.U50488 was perfused for a period of 5 min before and 30 min after reperfusion. Results:U50488H significantly reduced infarct size as a percentage of ischemic area (12.2 ± 1.9% in U50-1 and 7.2 ± 1.7% in U50-10, P ＜ 0.001) compared to the control hearts (27.2 ± 1.2%). After 2 hrs of reperfusion, left ventricular developed pressure was significantly recovered by U50488H (62.6 ± 5.7% in U50-1 and 68.6 ± 4.7% in U50-10, P = 0.018 and 0.002, respectively) compared to the control (46.3 ± 4.4%). Rate-pressure product was improved by 10μM U50488H (62.3 ± 5.5%, P = 0.007) but not by 1μM U50488H (50.0 ± 4.1%) compared to the control (44.7 ± 4.5%). U50488H significantly increased the ＋dP/dtmax (77.9 ± 5.5% in U50-1 and 78.0 ± 4.3 in U50-10, P = 0.005 and 0.001 vs. control, respectively). The −dP/dtmin also improved by 10μM U50488H (64.7 ± 4.8%, P = 0.003) compared to control (47.0 ± 2.7%). Conclusions:U50488H given at early reperfusion phase reduces both infarct size and myocardial stunning in isolated rat hearts.
Prospective evaluation of pain, swelling, and disability from copperhead envenomation

Abstract Context: In light of the existing controversy regarding antivenin treatment for copperhead envenomation, a more detailed analysis of the disability from this species is needed. Objective: Our objective was to prospectively determine the duration of pain, swelling, and functional disability, i.e., residual venom effects, in patients with copperhead envenomation. Methods: Patients with venomous snakebite reported to the North Texas Poison Center between April 2009 and November 2011 were assessed. Patients with confirmed envenomations were contacted by a specialist in poison information. Day zero was the day of the bite and verbal phone consent for study enrollment was obtained at that time. The patient (or their guardian) was contacted by phone daily thereafter, and asked to rate their pain, edema/swelling, and disability using the modified DASH and LEFS scales. Patients were followed to resolution of all symptoms or return to baseline. Results: About 104 cases of venomous snakebite were followed; of which 17 were excluded due to being a dry bites (5) or for having insufficient data during follow-up (11) or due to coagulopathy (1). Overall, residual venom effects from copperhead bites for most patients last between 7 and 13 days. Median time to complete pain resolution was 7 days (mean = 10.7 days). Median length of time to resolution of swelling was 10 days (mean = 13 days) and median length of time to resolution of functional disability was 9 days (mean = 12.2 days). Discussion: Residual venom effects from copperhead envenomation in this study had a slightly shorter duration than some other studies. Data are skewed due to outliers where residual venom effects lasted for up to 89 days. Initial reoccurrence of some symptoms may be seen. Antivenom (AV) is currently being used for a large percentage of patients with copperhead envenomation. Finally, no differences in duration of venom effects were seen based on age or location of bite. Conclusion: Our study suggests that residual venom effects from copperhead species persist for between 10 and 13 days but may persist for months. Future studies are necessary to identify risk factors for severe/prolonged injury and to define the benefit of AV in patients with copperhead envenomation.
Impact of Wall Thickness and Saccular Geometry on the Computational Wall Stress of Descending Thoracic Aortic Aneurysms

Background— Wall stress calculated using finite element analysis has been used to predict rupture risk of aortic aneurysms. Prior models often assume uniform aortic wall thickness and fusiform geometry. We examined the effects of including local wall thickness, intraluminal thrombus, calcifications, and saccular geometry on peak wall stress (PWS) in finite element analysis of descending thoracic aortic aneurysms. Methods and Results— Computed tomographic angiography of descending thoracic aortic aneurysms (n=10 total, 5 fusiform and 5 saccular) underwent 3-dimensional reconstruction with custom algorithms. For each aneurysm, an initial model was constructed with uniform wall thickness. Experimental models explored the addition of variable wall thickness, calcifications, and intraluminal thrombus. Each model was loaded with 120 mm Hg pressure, and von Mises PWS was computed. The mean PWS of uniform wall thickness models was 410±111 kPa. The imposition of variable wall thickness increased PWS (481±126 kPa, P<0.001). Although the addition of calcifications was not statistically significant (506±126 kPa, P=0.07), the addition of intraluminal thrombus to variable wall thickness (359±86 kPa, P⩽0.001) reduced PWS. A final model incorporating all features also reduced PWS (368±88 kPa, P<0.001). Saccular geometry did not increase diameter-normalized stress in the final model (77±7 versus 67±12 kPa/cm, P=0.22). Conclusions— Incorporation of local wall thickness can significantly increase PWS in finite element analysis models of thoracic aortic aneurysms. Incorporating variable wall thickness, intraluminal thrombus, and calcifications significantly impacts computed PWS of thoracic aneurysms; sophisticated models may, therefore, be more accurate in assessing rupture risk. Saccular aneurysms did not demonstrate a significantly higher normalized PWS than fusiform aneurysms.
George Goodheart, Jr., D.C., and a history of applied kinesiology.

: Applied Kinesiology (AK), founded by Michigan chiropractor George J. Goodheart, Jr., is a popular diagnostic and therapeutic system used by many health care practitioners. Many of the components in this method were discovered by serendipity and observation. In 1964, Goodheart claimed to have corrected a patient's chronic winged scapula by pressing on nodules found near the origin and insertion of the involved serratus anterior muscle. This finding led to the origin and insertion treatment, the first method developed in AK. Successive diagnostic and therapeutic procedures were developed for neurolymphatic reflexes, neurovascular reflexes and cerebrospinal fluid flow from ideas originally described by Frank Chapman, D.O. , Terrence J. Bennett, D.C., and William G. Sutherland, D.O. , respectively. Later, influenced by the writings of Felix Mann, M.D., Goodheart incorporated acupuncture meridian therapy into the AK system. Additionally, the vertebral challenge method and therapy localization technique, both based on phenomena proposed by L. L. Truscott, D.C., were added to the AK system. Scholarship has also evolved regarding AK and research on the topic is in its infancy. This paper documents some of the history of AK.
MetaCost: a general method for making classifiers cost-sensitive

Research in machine learning, statistics and related fields has produced a wide variety of algorithms for classification. However, most of these algorithms assume that all errors have the same cost, which is seldom the case in KDD problems. Individually making each classification learner costsensitive is laborious, and often non-trivial. In this paper we propose a principled method for making an arbitrary classifier cost-sensitive by wrapping a cost-minimizing procedure around it. This procedure, called MetaCost, treats the underlying classifier as a black box, requiring no knowledge of its functioning or change to it. Unlike stratification, MetaCost, is applicable to any number of classes and to arbitrary cost matrices. Empirical trials on a large suite of benchmark databases show that MetaCost almost always produces large cost reductions compared to the cost-blind classifier used (C4.5RULES) and to two forms of stratification. Further tests identify the key components of MetaCost and those that can be varied without substantial loss. Experiments on a larger database indicate that MetaCost scales well.
On Diabetes: Insulin Resistance Cellular Mechanisms of Insulin Resistance

It is estimated that by the year 2020 there will be approximately 250 million people affected by type 2 diabetes mellitus worldwide (1). Although the primary factors causing this disease are unknown, it is clear that insulin resistance plays a major role in its development. Evidence for this comes from (a) the presence of insulin resistance 10–20 years before the onset of the disease (2, 3); (b) cross-sectional studies demonstrating that insulin resistance is a consistent finding in patients with type 2 diabetes (3–6); and (c) prospective studies demonstrating that insulin resistance is the best predictor of whether or not an individual will later become diabetic (2, 3). Here, I focus on some recent advances in our understanding of human insulin resistance that have been made using nuclear magnetic resonance spectroscopy (NMR). This technique takes advantage of the spin properties of the nuclei of certain isotopes, such as 1 H, 13 C, and 31 P, which endow the isotopes with a magnetic component that can be used to measure the concentration of intracellular metabolites noninvasively and to assess biochemical differences between normal and diabetic subjects. Drawing on NMR studies from my laboratory and others, I first consider the control of glucose phosphorylation and transport in regulating muscle responses to insulin. I then turn to the effects of fatty acids on insulin responses , showing that commonly accepted models that attempt to explain the association of insulin resistance and obesity are incompatible with recent findings. Finally , I propose an alternative model that appears to fit these and other available data. Contributions of muscle glycogen synthesis to whole-body insulin-stimulated glucose metabolism Our initial studies addressed two questions. First, what is the contribution of insulin-stimulated muscle glyco-gen synthesis to whole-body insulin-stimulated glucose metabolism in normal individuals? Second, to what extent is this process defective in patients with type 2 diabetes (7)? We have measured rates of muscle glycogen synthesis using 13 C NMR spectroscopy to monitor the rate of [1-13 C]glucose incorporation into muscle glyco-gen. Under steady-state plasma concentrations of insulin and glucose that mimic postprandial conditions, we found that muscle glycogen synthesis was approximately 50% lower in diabetic subjects than in normal volunteers. When the mean rate of muscle glycogen synthesis was extrapolated to the whole body, the synthesis of muscle glycogen accounted for most of the whole-body glucose uptake, and virtually all of the nonoxidative glucose metabolism in both normal …
Technology Interventions for Elderly People

The population is ageing worldwide. The demographic change accompanied with fast changing family structure due to forces like urbanization and migration necessitate that vast resources will be required towards support, care and treatment of older persons. With massive increase in older population and ageing people, unprecedented challenges are found in the field of health care, infrastructure support, quality of life, etc. The use of technology to support comfortable and dignified living of older persons is mentioned in recent Government policy documents (e.g. National Policy on Older Persons). There exists a vast scope of technology interventions for welfare of elderly people in the country so that the technologies are accessible, affordable and adaptable to the specific needs. This paper tries to capture some of these new initiatives and suggest a roadmap for future activities in the area based on technological developments in Indian context.
From Sample to Population: Using and Reporting Inferential Statistics

This paper is a guide to authors on using and reporting inferential statistics in scientific papers. In particular, it deals with errors often found in manuscripts submitted for publication, some of which may be corrected and some of which are impossible to change because of design problems in the research. Examples are provided to illustrate the points made and to guide the potential researcher through the presentation of statistical information.
Physical Activity Patterns of Singaporean Adolescents

The purpose of this study was to document the level of physical activity and sedentary behavior in a representative sample of Singaporean adolescents. A random sample of 1,827 secondary school students from six secondary schools (929 boys, 898 girls, mean age 14.9 +/- 1.2 yr) completed the Three-Day Physical Activity Recall (3DPAR) self-report instrument. Approximately 63% of Singaporean high school students met current guidelines requiring 60 min of moderate to vigorous physical activity daily. Just over half (51.6%) met the guideline calling for regular vigorous physical activity. Across all grade levels, boys were consistently more active than girls. More than 70% of Singaporean high school students exceeded the recommended 2 hours per day of electronic media use. Collectively, these findings suggest that a significant proportion of Singaporean adolescents are not sufficiently active and are in need of programs to promote physical activity and decrease sedentary behavior.
Isolation and characterization of 10 microsatellite loci in Cneorum tricoccon (Cneoraceae), a Mediterranean relict plant.

PREMISE OF THE STUDY The main aim of this study was to isolate and characterize microsatellite loci in Cneorum tricoccon (Cneoraceae), a Mediterranean shrub relict of the early Tertiary, which inhabits western Mediterranean islands and coasts. Microsatellites will be useful for investigating biogeography and landscape genetics across the species distribution range, including current or past gene flow. METHODS AND RESULTS Seventeen microsatellite loci were characterized, of which 10 were polymorphic and amplified for a total of 56 alleles in three populations of C. tricoccon. The markers revealed average coefficients of expected heterozygosity (H(e) = 0.425), observed heterozygosity (H(o) = 0.282), and inbreeding coefficient value per population (F(IS) = 0.408). CONCLUSIONS These microsatellite primers will potentially be useful in the study of population and landscape genetics, conservation status of isolated populations, island-continental distribution, current or historical movements between populations, and in the investigation of the consequences of dispersal mechanisms of these plants.
Actual and Perceived Physical Competence in Overweight and Nonoverweight Children

This study compared actual and perceived physical competence of overweight and nonoverweight children. Participants were 109 nonoverweight and 33 overweight Grade 5 and 6 children (mean age 10.8 years). Overweight status was determined using age- and gender-specific international body-mass-index cut-off values. Actual competence was assessed using the Test of Gross Motor Development, 2nd ed., and perceived competence was assessed using an expanded version of the Athletic Competence subscale of the Self-Perception Profile for Children (SPPC). Overweight children had significantly lower actual and perceived physical competence. When actual competence was partitioned into locomotor and object-control skills, however, differences only existed for locomotor skills. These findings indicate that low actual and perceived physical competence might be important contributing factors in maintaining childhood obesity. Interventions to improve actual and perceived physical competence in overweight children should provi.