Miracle-dz/UniFAR-FTUs huggingface dataset:
A dynamic capabilities view of improvement capability

Purpose Organisations within healthcare increasingly operate in rapidly changing environments and present wide variation in performance. It can be argued that this variation is influenced by the capability of an organisation to improve: its improvement capability. However, there is little theoretical research on improvement capability. The purpose of this paper is to set out the current diverse body of research on improvement capability and develop a theoretically informed conceptual framework. Design/methodology/approach This paper conceptualises improvement capability as a dynamic capability. This suggests that improvement capability is comprised of organisational routines that are bundled together, and adapt and react to organisational circumstances. Existing research conceptualises these bundles as three elements (microfoundations): sensing, seizing and reconfiguring. This conceptualisation is used to explore how improvement capability can be understood, by inductively categorising eight dimensions of improvement capability to develop a theoretically informed conceptual framework. Findings This paper shows that the three microfoundations which make up a dynamic capability are present in the identified improvement capability dimensions. This theoretically based conceptual framework provides a rich explanation of how improvement capability can be configured. Originality/value Identifying the component parts of improvement capability helps to explain why some organisations are less successful in improvement than others. This theoretically informed framework can support managers and policy makers to identify improvement capability dimensions in need of development. Further empirical research, particularly in non-market settings, such as publicly funded healthcare is required to enhance understanding of improvement capability and its configuration.
Leukemic stem cell phenotype is associated with mutational profile in acute myeloid leukemia

Background/Aims Understanding leukemic stem cell (LSC) is important for acute myeloid leukemia (AML) treatment. However, association of LSC with patient prognosis and genetic information in AML patients is unclear. Methods Here we investigated the associations between genetic information and the various LSC phenotypes, namely multipotent progenitor (MPP)-like, lymphoid primed multipotent progenitor (LMPP)-like and granulocyte-macrophage progenitors (GMP)-like LSC in 52 AML patients. Results In secondary AML patients, MPP-like LSC was significantly higher than de novo AML (p = 0.0037). The proportion of MPP-like LSC was especially high in post-myeloproliferative neoplasm AML (p = 0.0485). There was no correlation between age and LSC phenotype. Mutations of KRAS and NRAS were observed in MPP-like LSC dominant patients, TP53 and ASXL1 mutations in LMPP-like LSC dominant patients, and CEBPA, DNMT3A and IDH1 mutations in GMP-like LSC dominant patients. Furthermore, KRAS mutation was significantly associated with MPP-like LSC expression (p = 0.0540), and TP53 mutation with LMPP-like LSC expression (p = 0.0276). When the patients were separated according to the combined risk including next generation sequencing data, the poorer the prognosis, the higher the LMPP-like LSC expression (p = 0.0052). This suggests that the dominant phenotype of LSC is one of the important factors in predicting the prognosis and treatment of AML. Conclusions LSC phenotype in AML is closely associated with the recurrent mutations which has prognostic implication. Further research to confirm the meaning of LSC phenotype in the context of genetic aberration is warranted.
Maternal Anthropometry and Dietary Diversity Associated with Birth Weight in Maternity Hospitals in Abidjan (Côte d’Ivoire)

Aims: Birth weight is a powerful predictor of infant growth and survival and depends on the fetal growth environment, which is influenced by maternal nutritional status. However, the association between maternal anthropometric and nutritional factors and birth weight is not well characterized in Côte d'Ivoire. The objective of this study was to determine the maternal anthropometric and nutritional characteristics associated with birth weight. Study Design: This was a retrospective study. Place and Duration of Study: This study was done in maternity hospitals of three municipalities in Abidjan, Côte d'Ivoire, from 1st October to 30 November 2018. Methodology: It consisted in collecting birth data from 146 newborns born from a monofetal pregnancy, whose mothers aged 20 to 42 had participated in a previous survey. Also, the relationship between birth weight, maternal anthropometry and maternal nutrition factors has been studied. Univariate, bivariate and multivariate data analysis was done using SPSS version 25 software. Results: The results indicate mean birth weight of 3118.48±515.39 g and 7.6% and 5.5% respectively of low and excessive birth weight. In a multivariate linear regression, the mean birth weight of newborns of women with medium and high dietary diversity score was higher than those newborn of women with low dietary diversity score (AOR=0.386, 95% confidence interval (CI): 0.072-0.699; p=0.017 and AOR=0.233, 95% CI: 0.016-0.450; p=0.036). Similarly, women with gestational weight gain greater than 7 kg and high stature (>1.55 cm) gave birth to heavier children (AOR=0.551, 95% CI: 0.346-0.756; p=0.000 and AOR=0.633, 95% CI: 0.207-1.059; p=0.004, respectively). Conclusion: Although it revealed the presence of low and excess birth weight, this study has shown that maternal anthropometry and dietary diversity score were associated with birth weight of the baby.
Sitting time in young children at childcare: Prevalence, health consequences and intervention effects

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The Antidepressant-Like Effects of Menthol through Dopaminergic System Using Forced Swimming Test in a Mice Model

Checked for Plagiarism: Yes Peer reviewers approved by: Dr. Melika Andrew Language Editor: Dr. Valentina Apakidze Editor who approved publication: Prof. Dr. Nanuli Doreulee Abstract Background and purpose: Antioxidants are known to have protective and beneficial effects in the depression. Menthol is an antioxidant compounds in some plants. On the basis of our knowledge, no scientific study has investigated the antidepressant-like effects of menthol. Therefore, present study was thus conducted to evaluate the antidepressant-like effects of menthol by forced swimming test (FST) through dopaminergic system in a mice model. Materials and Methods: The mice were intra-peritoneally (i.p.) administrated with menthol (10-30 mg/kg) 1 h before the FST. For evaluating the involvement of the dopaminergic system in the antidepressant activity of menthol, SCH 23390 (a dopamine D1 receptor antagonist), sulpiride (a dopamine D2 receptor antagonist) and haloperidol (non-selective dopamine receptor antagonist) were administered 15 min before menthol administration (10 mg/kg). Results: Intra-peritoneally administration of menthol reduced immobility time and increased swimming and climbing times. It did not also cause significant changes in spontaneous locomotor function in the open-field test (OFT). In addition, pre-treatment of the mice with SCH23390, sulpiride, haloperidol blocked the anti-immobility effect of menthol in the FST. Conclusion: Administration of menthol exerted antidepressant-like effects through dopaminergic (D1 and D2) system.
Application of High-Sensitivity Troponin in Suspected Myocardial Infarction.

Neumann, Johannes T. , Twerenbold, Raphael, Ojeda, Francisco, Sörensen, Nils A. , Chapman, Andrew R. , Shah, Anoop S.V. , Anand, Atul, Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Mokhtari, Arash, Pickering, John W. , Troughton, Richard W. , Greenslade, Jaimi, Parsonage, William, Mueller-Hennessen, Matthias, Gori, Tommaso, Jernberg, Tomas, Morris, Niall, Liebetrau, Christoph, Hamm, Christian, Katus, Hugo A. , Münzel, Thomas, Landmesser, Ulf, Salomaa, Veikko, Iacoviello, Licia, Ferrario, Marco M. , Giampaoli, Simona, Kee, Frank, Thorand, Barbara, Peters, Annette, Borchini, Rossana, Jørgensen, Torben, Söderberg, Stefan, Sans, Susana, Tunstall-Pedoe, Hugh, Kuulasmaa, Kari, Renné, Thomas, Lackner, Karl J., Worster, Andrew, Body, Richard, Ekelund, Ulf, Kavsak, Peter A. , Keller, Till, Lindahl, Bertil, Wild, Philipp, Giannitsis, Evangelos, Than, Martin, Cullen, Louise A. , Mills, Nicholas L. , Mueller, Christian, Zeller, Tanja, Westermann, Dirk, & Blankenberg, Stefan (2019) Application of high-sensitivity troponin in suspected myocardial infarction. The New England Journal of Medicine, 380(26), pp. 2529-2540.
Experts Perception of Patient-Reported Outcomes (PROs) in a Danish Context

This paper elucidates the understanding of Patient-Reported Outcomes (PROs) among experts in a Danish context. PROs are currently implemented on a regional and national level in Denmark (DK); even though, their purpose and functionality seem unclear. Methodologically the study is based on seven semi-structured interviews with core PRO-experts. PRO was identified as: data on an individual/population level; an active/passive functionality; contextual dependent; quality improvements; Value-Based Healthcare; patient-centred care; part of clinical practice; technology and as an economic tool. An analysis of the discrepancies among PRO-experts reveals that their perceptions are associated with their experiences and/or organizational positions.
Does race impact functional outcomes in patients undergoing robotic partial nephrectomy?

Background The role of race on functional outcomes after robotic partial nephrectomy (RPN) is still a matter of debate. We aimed to evaluate the clinical and pathologic characteristics of African American (AA) and Caucasian patients who underwent RPN and analyzed the association between race and functional outcomes. Methods Data was obtained from a multi-institutional database of patients who underwent RPN in 6 institutions in the USA. We identified 999 patients with complete clinical data. Sixty-three patients (6.3%) were AA, and each patient was matched (1:3) to Caucasian patients by age at surgery, gender, Charlson Comorbidity Index (CCI) and renal score. Bivariate and multivariate logistic regression analyses were used to evaluate predictors of acute kidney injury (AKI). Kaplan-Meier method and multivariable semiparametric Cox regression analyses were performed to assess prevalence and predictors of significant eGFR reduction during follow-up. Results Overall, 252 patients were included. AA were more likely to have hypertension (58.7% vs. 35.4%, P=0.001), even after 1:3 match. Overall 42 patients (16.7%) developed AKI after surgery and 35 patients (13.9%) developed significant eGFR reduction between 3 and 15 months after RAPN. On multivariate analysis, AA race did not emerge as a significant factor for predicting AKI (OR 1.10, P=0.8). On Cox multivariable analysis, only AKI was found to be associated with significant eGFR reduction between 3 and 15 months after RAPN (HR 2.49, P=0.019). Conclusions Although African American patients were more likely to have hypertension, renal function outcomes of robotic partial nephrectomies were not significantly different when stratified by race. However, future studies with larger cohorts are necessary to validate these findings.
表观弥散系数在2~12岁常规颅脑MRI正常的智力障碍/全面发育迟缓患儿中的应用

目的探讨快速自旋回波弥散加权成像（TSE-DWI）表观弥散系数（ADC）在2~12岁常规颅脑MRI正常的智力障碍/全面发育迟缓（ID/GDD）患儿中的应用价值。 方法选择符合ID/GDD诊断标准且常规颅脑MRI正常的578例患儿及同年龄段375例正常儿童志愿者为研究对象，并收集其影像学和临床资料。 所有研究对象均行颅脑TSE-DWI序列及常规序列扫描。 分析正常对照组儿童各脑区不同年龄亚组、各年龄亚组不同ID/GDD程度患儿各脑区ADC值差异，社会适应行为评分（ABAS-Ⅱ）对ID/GDD患儿各脑区ADC值的影响。 结果正常对照组额颞叶白质、胼胝体、内囊、半卵圆中心、小脑齿状核、视放射、丘脑、豆状核及尾状核ADC值随年龄升高而降低（P 结论ADC能反映常规颅脑MRI正常ID/GDD患儿各脑区细微结构变化，对社会适应性方面也有一定的提示作用，可为ID/GDD患儿定量诊断提供客观依据。
Risk of pressure injury in the ICU: transcultural adaptation and reliability of EVARUCI

Abstract Objective Perform a transcultural adaptation of the current risk assessment scale for pressure injuries in intensive care (Escala de Valoracion Actual del riesgo de desarrollar Ulceras por presion en Cuidados Intensivos – EVARUCI) to Brazilian Portuguese and analyze its reliability among intensive care unit (ICU) patients. Methods Methodological study for transcultural adaptation and reliability analysis of the EVARUCI. Internal consistency was verified using Cronbach’s alpha coefficient. Inter-rater agreement was verified using the simultaneous application of the final version of [. ]
Auditory results with multicanal cochlear implant in patients submitted to cochlear implant surgery at University of São Paulo Medical School - Hospital das Clínicas

Complete hearing loss is a very important handicap resulting in sensory deprivation and affecting an individual's personality, relationships and life style. Individuals with profound deafness are unable to hear environmental sounds as doorbells, telephones, traffic noises and sirens that are an important alert for dangerous situations in the daily life. They are also unable to hear their own voices and for this people with profound deaf do not modulate their voices. The hearing aids are the first choice to treat deafness, but there are patients with severe damage of the auditory systems who cannot receive a useful hearing from normal hearing aids. The cochlear implant is the alternative for patients that cannot have good discriminatory ability wearing a powerful hearing aid and wish or need a better hearing. AIM: To study the hearing results of the adult patients who are using a multichannel cochlear implant system at the Department of Otolaryngology - University of Sao Paulo. STUDY DESIGN: Series study. MATERIAL AND METHOD: We selected 61 patients with a severe bilateral hearing loss that have been using the cochlear implant for at least six months. The hearing evaluation performed after using the device for six months included word and sentence recognition tests. RESULTS: The PTA of four patients reached 38.7 dB. Speech perception tests showed 713% recognition of open set sentences, 86.5% of vowels and 52.60% of monosyllabic. Most of our patients are able to speak on the telephone. CONCLUSION: Most of patients showed excellent results in open-set sentence and word tests.
Phytochemical and in vitro anticancer activity of Cassia glauca leaves extract

Aim: Cassia glauca leaves are extracted and studied for preliminary chemicals present in the extracts and studied for in vitro anticancer activity against human cell lines using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Results: Preliminary phytochemical screening of ether extract shows the presence of glycosides, flavonoids, and phenols, and chloroform and methanol extracts show the presence of glycosides, flavonoids, and phenols, and alkaloids and methanol extract shows the presence of glycosides, alkaloids, steroids, and flavonoids. The viability of the extracts has shown significantly decreased at 1000 μg/ml after 72 h against cancer cells. Ether extract shown significant anticancer activity against MCF-7 (23.76%, half maximal inhibitory concentration [IC50] – 479.63) and HT-29 (36.18%, IC50 – 583.71), and chloroform and methanol extracts show significant anticancer activity against A549 (26.04%, IC50 – 282.27) and A549 (35.52%, IC50 – 636.30) cancer cells. Conclusion: The results indicate that C. glauca leaves ether extract shows significant anticancer activity against MCF-7 and HT-29, and chloroform and methanol extracts show against A549, the activity may be due to the presence of flavonoids and polyphenols.
Prospective Evaluation of HIV Testing Technologies in a Clinical Setting: Protocol for Project DETECT

Background HIV testing guidelines provided by the Centers for Disease Control and Prevention (CDC) are continually changing to reflect advancements in new testing technology. Evaluation of existing and new point-of-care (POC) HIV tests is crucial to inform testing guidelines and provide information to clinicians and other HIV test providers. Characterizing the performance of POC HIV tests using unprocessed specimens can provide estimates for the window period of detection, or the time from HIV acquisition to test positivity, which allows clinicians and other HIV providers to select the appropriate POC HIV tests for persons who may be recently infected with HIV. Objective This paper describes the protocols and procedures used to evaluate the performance of the newest POC tests and determine their sensitivity during early HIV infection. Methods Project DETECT is a CDC-funded study that is evaluating POC HIV test performance. Part 1 is a cross-sectional, retrospective study comparing behavioral characteristics and HIV prevalence of the overall population of the Public Health–Seattle & King County (PHSKC) Sexually Transmitted Disease (STD) Clinic to Project DETECT participants enrolled in part 2. Part 2 is a cross-sectional, prospective study evaluating POC HIV tests in real time using unprocessed whole blood and oral fluid specimens. A POC nucleic acid test (NAT) was added to the panel of HIV tests in June 2018. Part 3 is a longitudinal, prospective study evaluating seroconversion sensitivity of POC HIV tests through serial follow-up testing. For comparison, HIV-1 RNA and HIV-1/HIV-2 antigen/antibody tests are also performed for participants enrolled in part 2 or 3. A behavioral survey that collects information about demographics, history of HIV testing, STD history, symptoms of acute HIV infection, substance use, sexual behaviors in the aggregate and with recent partners, and use of pre-exposure prophylaxis and antiretroviral therapy is completed at each part 2 or 3 visit. Results Between September 2015 and March 2019, there were 14,990 Project DETECT–eligible visits (part 1) to the PHSKC STD Clinic resulting in 1819 part 2 Project DETECT study visits. The longitudinal study within Project DETECT (part 3) enrolled 27 participants with discordant POC test results from their part 2 visit, and 10 (37%) were followed until they had fully seroconverted with concordant positive POC test results. Behavioral survey data and HIV test results, sensitivity, and specificity will be presented elsewhere. Conclusions Studies such as Project DETECT are critical for evaluating POC HIV test devices as well as describing characteristics of persons at risk for HIV acquisition in the United States. HIV tests in development, including POC NATs, will provide new opportunities for HIV testing programs. International Registered Report Identifier (IRRID) RR1-10.2196/16332
Prevalence of inversions in introns 1 and 22 of the factor VIII gene and inhibitors in patients from southern Brazil

Objectives: The development of antibodies (inhibitors) against exogenous factors is the main complication in the treatment of hemophilia. Both genetic and non-genetic factors are related to inhibitor development. Among the genetic factors, the type of mutation that caused the disease is one of the most important. The objectives of the present study were to establish the prevalence of inversions in introns 1 and 22 of the factor VIII gene in patients with severe hemophilia A, correlating these with inhibitor development, and to compare the results with data from the literature. Method: Unrelated severe hemophilia A patients were analyzed for the presence of inversions in intron 1 ( n = 77) and intron 22 ( n = 39) by polymerase chain reaction (PCR). Detection of the inhibitor was performed by the mixing test and its quantification was performed by the Bethesda method. Results: The prevalence of inversions in introns 1 and 22 was 2.6% and 41%, respectively. No patient with inversions in intron 1 had inhibitors, whereas 26.3% of patients with inversions in intron 22 developed inhibitors. Conclusion: Due to the small number of patients with inversions in intron 1, it was not possible to perform a statistical test for the correlation with risk of inhibitor development. Inversions in intron 22 of the factor VIII gene were not associated with an increased risk of inhibitor development in the analyzed samples ( p = 1).
EFFECTIVENESS OF PREEMPTIVE ANALGESIA IBUPROFEN 10 MG / KGBB PER ORAL FOR POSTOPERATIVE PAIN MANAGEMENT IN CHILDREN UNDERGOING MASS CIRCUMCISION

Management of post-mass circumcision pain is often overlooked and not optimal because the administration of analgesia will be given when circumcision is complete. This study aims to determine the effectiveness of oral 10 mg / KGBB ibuprofen as preemptive analgesia for the management of post mass circumcision pain. After obtaining permission from the ethics commission of the FK UMSU clinical research, a prospective double-blind randomized controlled clinical trial was conducted on 28 children in consecutive sampling who met the inclusion and exclusion criteria. Samples were randomized into 2 groups, A was given ibuprofen 10 mg/kg BW orally 1 hour before incision and B was given ibuprofen 10 mg/kg BW orally at the time immediately after the circumcision was completed. Pain scale measurements were performed using FPR-S (Faces Pain Scale-Revised) at the 1st, 2nd, 4th, 6th and 8th postoperative hours. Monitoring of the 1st to 4th hours is carried out at the location of the activity, while the 6th to 8th hours are carried out by telephone. There was a significant decrease in pain scale at the 1st hour (p = 0.031) in group A. At the second to eighth-hour monitoring, the effectiveness of the two methods was the same. In conclusion, the method of preemptive analgesia is effective for the management of post-mass circumcision pain. Keywords: preemptive analgesia, post-circumcision pain
Machine Learning Models for Analysis of Vital Signs Dynamics: A Case for Sepsis Onset Prediction

Objective Achieving accurate prediction of sepsis detection moment based on bedside monitor data in the intensive care unit (ICU). A good clinical outcome is more probable when onset is suspected and treated on time, thus early insight of sepsis onset may save lives and reduce costs. Methodology We present a novel approach for feature extraction, which focuses on the hypothesis that unstable patients are more prone to develop sepsis during ICU stay. These features are used in machine learning algorithms to provide a prediction of a patient's likelihood to develop sepsis during ICU stay, hours before it is diagnosed. Results Five machine learning algorithms were implemented using R software packages. The algorithms were trained and tested with a set of 4 features which represent the variability in vital signs. These algorithms aimed to calculate a patient's probability to become septic within the next 4 hours, based on recordings from the last 8 hours. The best area under the curve (AUC) was achieved with Support Vector Machine (SVM) with radial basis function, which was 88.38%. Conclusions The high level of predictive accuracy along with the simplicity and availability of input variables present great potential if applied in ICUs. Variability of a patient's vital signs proves to be a good indicator of one's chance to become septic during ICU stay.