Miracle-dz/UniFAR-FTUs huggingface dataset:
Giving Voice to Patients Through Interviews and Qualitative Analysis

In quality improvement, the "voice of the customer" is a concept that prioritizes how a "process customer" would view the processes, events, and outcomes of a workflow or process. To fill a gap in awareness of the patient experience of the radiology processes, we used a qualitative approach to elicit the patient view of their radiology experiences, and attempt to develop a typology and insights from the patient voice. We telephonically interviewed n=8 radiology patients and one carer of a juvenile radiology patient using a mixed-methods approach. We developed a typology of patient experiences of the radiology processes that centered on communication gaps, and reflected opacity, fragility, and unpredictability of administrative and care processes in radiology.
Twitter and Pain: An Observational Analysis of Pain-Related Tweets in Ireland

Introduction Studies involving Twitter and chronic pain can provide highly valuable patient generated information. The aim of this paper was to examine pain related tweets in Ireland over a two week period 22nd June 2017 to 5th July 2017 using pain related keywords. We wished to identify demographic details regarding the Twitter users; most common topics discussed; sentiment analysis; and reach of tweets Methods A third party data analytics company used 24 pain related keywords over a 14 day period between the dates 22nd June to 5th July 2017. Results There were 941 tweets identified during the study from 715 contributors. These reached 2.62 million accounts and generated 2.88 million impressions. The most frequently occurring keywords were headache (n=321); migraine (n=147); back pain (n=123); cannabis (n=114); and chronic pain (n=85). There were 1.94 times as many tweets from females as males. The highest proportion of tweets from female users was in the fibromyalgia (83%) and migraine (60%) categories, and from males in the sciatica (35%), chronic pain (34%) and back pain (32%) categories. Cannabis related tweets reflected mostly non personal content (90%), with a highly positive sentiment, and the highest reach per tweet. The largest amount of advice was offered in the back pain category. Retweets were more likely to reflect a positive sentiment. Conclusion A substantial discussion of pain related topics took place on Twitter during our study period. This provided real time, dynamic information from individuals on discussion topics in pain medicine. This can be used to gain a greater understanding of the pain experience. As patients are increasingly acquiring healthcare information through online sources, high quality information from approved sources should be promoted on such platforms.
Operationalisation of the learned non-use phenomenon - A Delphi study.

The discrepancy between residual functional capacity and reduced use of the contralesional hand, frequently observed after a brain lesion, has been termed Learned Non-Use (LNU) and is thought to depend on the interaction of neuronal mechanisms during recovery and learning-dependent mechanisms such as negative reinforcement. Despite the generally accepted existence of the LNU phenomenon among clinicians and researchers, no unequivocal and transdisciplinary definition exists to date. Furthermore, although therapeutic approaches are implemented in clinical practice to explicitly target LNU, no standardized diagnostic routine is described in the current literature. Based on a structured group communication following the Delphi method among clinical and scientific experts in the field of LNU, knowledge from both, the work with patient populations and with animal models, was synthesized and integrated to reach consensus regarding a transdisciplinary definition of the LNU phenomenon. Furthermore, the mode and strategy of the diagnostic process, as well as the sources of information and outcome parameters relevant for the clinical decision making, were described with a wide range showing the current lack of a consistent universal diagnostic approach. Building on these results, the need for the development of a structured diagnostic procedure and its implementation into clinical practice is emphasized. Moreover, it exists a striking gap between the prevailing hypotheses regarding the mechanisms underlying the LNU phenomenon and the actual evidence. Therefore, basic research is needed to bridge between bedside and bench and eventually improve clinical decision making and further development of interventional strategies beyond the field of stroke rehabilitation.
Novel approach reveals lipid metabolite reduction in nails of breast cancer patients as potential biomarker

ABSTRACT: BACKGROUND: Molecular adaptations in intracellular and extracellular microenvironment of breast cancer cells promote pro-tumor metabolic reprogramming. Hence, metabolic reprogramming is seen as a crucial factor in various tumor hallmarks including drug resistance, invasiveness and metastasis. Among well-known metabolic features of breast carcinoma including Warburg effects, altered amino acid metabolism, lipid remodeling is considered as key factors in achieving pro-tumor microenvironment. Therefore, a better understanding on molecular aspects of lipid remodeling is highly appreciated that may contribute towards future therapeutics and diagnostics purpose including the need of potential biomarkers. The identification and validation of lipid biomarkers are reported in the literature, but evidence on lipid metabolites as biomarkers in nails of breast cancer patients is completely unexplored. METHODS: This study reported a novel and specifically designed vertical tube gel electrophoresis (VTGE) system to assist in the purification of metabolites in the range of (~100-1000 Da) from nail samples. Fingernail clippings of breast cancer patients (N=10), and healthy subjects (N-12) were used for extraction and purification of metabolites. The VTGE system uses 15% polyacrylamide under non-denaturing and non-reducing conditions that makes eluted metabolites directly compatible with LC-HRMS and other analytical techniques. The characterization of lipid metabolites in nail lysates was done by positive ESI mode of Agilent LC-HRMS platform. RESULTS: Data suggest a novel observation that healthy and breast cancer patients show distinct accumulation of lipid metabolites specifically choline-based lipids. This is a first report that suggests that levels of choline, phosphorylcholine and lyso-PC are highly reduced and undetectable in nails of breast cancer patients over healthy subject. Furthermore, the potential use of reduced level of choline, phosphorylcholine and lyso-PC in nails of breast cancer patients is in line with current notion that these lipids are diverted to meet the pro-tumor activities in the tumor microenvironment. CONCLUSION: Data strongly provide a proof of concept for the potential use of lipid metabolites including choline, phosphorylcholine and lyso-PC as a set of biomarkers in nails of breast cancer patients. However, the authors propose that validity of these lipid biomarkers may be extended to large population size of breast cancer patients for future applications in early detection, grading, staging, predicting prognosis and therapeutic targeting of breast carcinoma.
Association between dopamine receptor D2 genetic polymorphism TaqIA1 (C t) and susceptibility to alcohol dependence

Several studies are published , which investigated dopamine receptor 2 (DRD2) gene TaqIA polymorphism as ris factor for alcohol dependence (AD) with positive and negative association. To derive a more precise estimation of the relationship, a meta-analysis of case-control studies that examined the association between DRD2 gene Taq1A polymorphism and alcohol dependence were performed. Eligible articles were identified through search of databases including PubMed, Science Direct, Springer link and Google Scholar. The association between the DRD2 TaqIA polymorphism and AD susceptibility was conducted using odds ratios (ORs) and 95 % confidence intervals (95 % CIs) as association measure. A total of 69 studies with 9,125 cases and 9,123 healthy controls were included in current meta-analysis. Results of present analysis showed significant association between DRD2 TaqIA polymorphism and AD risk using a five genetic modes (allele contrast model -OR=1.22 , 95% CI=1.13-1.32, p<0.0001; homozygote model -OR= 1.35, 95%CI= 1.18-1.55; p= <0.0001; dominant model -OR= 1.29; 95%CI= 1.20-1.39; p<0.0001; recessive model-OR= 1.21; 95%CI= 1.08-1.36; p= 0.0006). There was no significant association found between In subgroup analysis, TaqIA polymorphism was not significantly associated with AD risk in Asian population under all genetic models, but in Caucasian population TaqIA polymorphism was significantly associated with AD risk. Overall, results support the hypothesis that DRD2 Taq1A polymorphism plays a role in alcohol dependence.
CALGARY NORMATIVE STUDY: STUDY DESIGN OF A PROSPECTIVE LONGITUDINAL STUDY TO CHARACTERIZE POTENTIAL QUANTITATIVE MR BIOMARKERS OVER THE ADULT LIFESPAN

Introduction: A number of magnetic resonance (MR) imaging methods have been proposed to be useful, quantitative biomarkers of neurodegeneration in aging. The Calgary Normative Study (CNS) is an ongoing single-centre, prospective, longitudinal study that seeks to develop, test and assess quantitative MR methods as potential biomarkers. The CNS has three objectives: first and foremost, to evaluate and characterize the dependence of the selected quantitative neuroimaging biomarkers on age over the adult lifespan; secondly, to evaluate the precision, variability and repeatability of quantitative neuroimaging biomarkers as part of biomarker validation providing proof of-concept and proof-of-principle; and thirdly, provide a shared repository of normative data for comparison to various disease cohorts. Methods and Analysis: Quantitative MR mapping of the brain including longitudinal relaxation time (T1), transverse relaxation time (T2), T2*, magnetic susceptibility (QSM), diffusion and perfusion measurements, as well as morphological assessments are performed. The Montreal Cognitive Assessment (MoCA) and a brief, self-report medical history will be collected. Mixed regression models will be used to characterize changes in quantitative MR biomarker measures over the adult lifespan. In this report on study design, we report interim prevalence and demographic information of recruitment from 28 May 2013 to 31 December 2018. Ethics and Dissemination: Participants provide signed informed consent. Changes in quantitative MR biomarkers measured over the adult lifespan as well as estimates of measurement variance and repeatability will be disseminated through peer-reviewed scientific publication.
Shut it down: a cross country panel analysis on the efficacy of lockdown measures

Coronavirus pandemic outbreak from China in the December 2019 and since then has quickly spread all over the world. National governments introduced policies aimed to reduce the probability to contract the virus, such as lockdown measures, in order to limit the outbreak. Lockdown fostered a debate about the effective need and the optimal duration of such measures. Indeed, these policies have a high price, being characterized by the alt of many productive activities. The aim of this note is to provide preliminary evidences about the efficacy of lockdown measures all over the world, by the means of a panel data quantitative analysis. Our results confirm the efficacy of such measures, and that the average time to have effects in terms of a reduction of cases is of about ten days. Furthermore the beneficial effects of a lockdown keep reducing the new cases with a linear trend for at least the ten successive days.
The impact of Attachment Styles and Defense Mechanisms on psychological distress in a non-clinical young adult sample: a path analysis.

Introduction. Insecure attachment styles and immature or neurotic defense mechanisms are related to psychological distress. However, their mutual interaction in influencing psychological distress deserves further investigation. Methods. One-thousand-one-hundred-twenty-nine University students were evaluated using the Global Severity Index of Symptoms Check List 90-Revised for psychological distress, Relationship Questionnaire for attachment styles and Defense Style Questionnaire for defense mechanisms. Following exploratory analyses, a Path Analysis was performed with psychological distress as outcome. Results. Fearful and preoccupied attachment styles had a substantial impact on psychological distress. About 30% of their effect was mediated by Immature and Neurotic defenses, with the former having the major effect. Dismissing attachment showed no substantial effect on psychological distress. Secure Attachment and Mature Defenses had a small protective effect on psychological distress, but their inclusion in the path model did not improve overall goodness-of-fit. Attachment style and defense mechanisms accounted for nearly 25% of the variance in psychological distress. Conclusions. The results showed that attachment styles and defense mechanisms have a substantial impact on psychological distress. The effect of attachment style is mediated by defense mechanisms. Individual differences in attachment style and defense mechanisms represent risk factors for psychological distress in young adults.
Estimating the probability of New Zealand regions being free from COVID-19 using a stochastic SEIR model

This report describes a method for estimating the probability that there are no infected or pre-symptomatic individuals in a populations on a basis of historical data describing the number of cases in consecutive days. The method involves fitting a stochastic version of Susceptible Exposed Infected Recovered model, and using the model to calculate the probability that the number of both exposed and infected individuals is equal to 0. The model is used to predict the current probabilities for all District Health Boards in New Zealand. These probabilities are highly correlated with the number of days with no new cases of COVID-19.
Changing hand appearance using visual illusions modulates body perception disturbance and pain in longstanding Complex Regional Pain Syndrome: A randomised trial

Effective treatment of longstanding Complex Regional Pain Syndrome (CRPS) is a challenge, as causal mechanisms remain elusive. People with CRPS frequently report distorted subjective perceptions of their affected limb. Evidence of pain reduction when the affected limb is visually altered in size, suggests that visual illusions used to target central processing could restore coherence of this disrupted limb representation. We hypothesised that using virtual reality that alters hand image to match the patients desired hand appearance, would improve body perception disturbance and pain. Also, repeated exposure would maintain any therapeutic effect. A blinded randomised controlled trial of 45 participants with refractory upper-limb CRPS and body perception disturbance (BPD) viewed a digital image of their affected hand for one minute. The image was digitally altered according to the patients description of how they desired their hand to look in the experimental group and unaltered in the control group. BPD and pain were measured pre and post-intervention. A subgroup was followed up two weeks after a course of repeated interventions. BPD (p=0.036, effect size (ES)=0.6) and pain intensity (p = 0.047, ES=0.5) reduced in 23 participants after single exposure compared to controls (n=22). At follow-up the subgroup (experimental n= 21; control n=18) showed sustained pain reduction only (p=0.037 ES=0.7), with an overall 1.2 decrease on an 11-point scale. Visually changing the CRPS hand to a desired appearance modulates BPD and pain suggesting therapeutic potential for those with refractory CRPS. Future detailed studies to optimise this therapeutic effect are required. Clinical Trial Registration ID #ISRCTN64093359.
Does the metabolic syndrome exist? The identification of cardio-metabolic profiles in a South Asian population study

OBJECTIVE Research testing the validity of the metabolic syndrome (MetS) as a clinical construct associated with cardiovascular disease risk has produced inconsistent results. This study tested the existence of the MetS, explored alternative cardiometabolic risk characterisations, and examined the relative influence of genetic and environmental factors in a South Asian sample. RESEARCH DESIGN AND METHODS Data came from the Colombo Twin and Singleton follow-up Study, CoTaSS-2 (N=3969). Latent class analysis tested the clustering of MetS indicators (waist circumference, high-density-lipoprotein cholesterol (HDL-C), triglycerides (TG), blood pressure, fasting plasma glucose (FPG), medications and diabetes). Regression analyses tested cross-sectional associations between identified latent classes and covariates. Structural equation modelling estimated genetic and environmental influences on these classes. Analyses were stratified by gender (n=1681 men, n=2288 women). RESULTS Three classes were identified in men: 1) "Healthy" (52.3%), 2) "Central obesity, high TG, high FPG" (40.2%), and 3) "Central obesity, high TG, diabetes" (7.6%). Four classes were identified in women: 1) "Healthy" (53.2%), 2) "Very high central obesity, low HDL-C, raised FPG" (32.8%), 3) "Very high central obesity, diabetes" (7.2%) and 4) "Central obesity, hypertension, raised FPG" (6.8%). Older age in men and women, and high socioeconomic status in men, was associated with cardiometabolic risk categories, compared to the "Healthy" classes. In men, individual differences in cardiometabolic class membership were due to environmental effects. In females, genetic differences significantly predicted class membership. CONCLUSIONS The findings did not support the MetS construct. Instead, distinct clinical profiles were identified in men and women, suggesting different aetiological pathways.
The Contribution of Age Structure to the Number of Deaths from Covid-19 in the UK by Geographical Units

This study investigates the contribution of population age structure to mortality from Covid-19 in the UK by geographical units. We project death rates at various spatial scales by applying data on age-specific fatality rates to the area's population by age and sex. Our analysis shows a significant variation in the projected death rates between the constituent countries of the UK, between its regions and within regions. First, Scotland and Wales have higher projected fatality levels from Covid-19 than England, whereas Northern Ireland has lower rate. Second, the infection fatality rates are projected to be substantially higher in small towns and rural areas than those in large urban areas. Third, our analysis shows that within urban regions there are also 'pockets' of high projected death rates. Overall, the areas with high and low fatality rates tend to cluster because of the high residential separation of different population age-groups in the UK. Our analysis also reveals that the Welsh-, Gaelic- and Cornish-speaking communities with relatively old populations are likely to experience heavy population losses if the virus spreads widely across the UK.
LabWAS: Novel findings and study design recommendations from a meta-analysis of clinical labs in two independent biobanks

Phenotypes extracted from Electronic Health Records (EHRs) are increasingly prevalent in genetic studies. EHRs contain hundreds of distinct clinical laboratory test results, providing a trove of health data beyond diagnoses. Such lab data is complex and lacks a ubiquitous coding scheme, making it more challenging than diagnosis data. Here we describe the first large-scale cross-health system genome-wide association study (GWAS) of EHR-based quantitative lab measurements. We meta-analyzed 70 labs matched between the BioVU cohort from the Vanderbilt University Health System and the Michigan Genomics Initiative (MGI) cohort from Michigan Medicine. We show high replication of known association for these labs, validating EHR-based measurements as high-quality phenotypes for genetic analysis. Notably, our analysis provides the first replication for 700 previous GWAS associations across 46 different labs. We discovered 31 novel associations at genome-wide significance for 22 distinct labs, including the first reported associations for two labs. We replicated 22 of these novel associations in an independent tranche of BioVU samples. The summary statistics for all association tests are available through an interactive webtool to benefit other researchers. Finally, we performed mirrored analyses in BioVU and MGI to assess competing analytic practices for lab data. We find that using the mean of all available lab measurements provides a robust summary value, but alternate summarizations can improve power in certain labs. This study provides a proof-of-principle for cross health system GWAS and is a framework for future studies of quantitative traits in EHRs.
Laparoscopic vs open gastrectomy. An updated metaanalysis of randomised control trials for short term outcomes and updated metaanalysis for long term over all and disease free survival outcomes.

Abstract: Introduction: Aim of this metaanalysis was to compare short term and long term survival outcomes of laparoscopic and open gastrectomy for gastric cancer. Material and methods: EMBASE, MEDLINE, PubMed and the Cochrane Database were searched for randomised control trials comparing outcomes in patients undergoing laparoscopic gastrectomies with those patients undergoing open gastrectomies. The primary outcome was 30 day morbidity and mortality and 5 year disease free and overall survivals. Secondary outcomes studied included length of stay, blood loss, d2gastrectomies, lymphnode retrieval, operative time, distal gastrectomy, wound complications, intraabdominal complications and systemic complications (pulmonary included). Systemic review and Metaanalysis were done according to MOOSE and PRISMA guidelines. Results: Morbidity was significantly low in laparoscopic group( P=0.004). There was no significant difference between mortality between the two groups. (P=0.989). There was no difference in wound complications, intra-abdominal complications or other systemic complications in both the groups.Operative time was significantly higher in laparoscopic group. ( P< 0.001) wmd 56.904. Hospital stay was significantly lesser in laparoscopic group. (P< 0.001) wmd -0.533 days. Blood loss was significantly lesser in laparoscopic group. (p <0.001). Laparoscopic group patients had less number of lymph node retrieval compared to laparoscopic group. (p< 0.001). Laparoscopic group also contained significantly lesser advanced staged gastric cancer than open gastrectomies. There was no significant difference between 5 year over all between the two groups. There was no difference in 5 year disease free survival in both the groups. Conclusions: Laparoscopic gastrectomies were associated with better short term outcomes with no difference in 5 year disease free and overall survival.