Miracle-dz/UniFAR-FTUs huggingface dataset:
Growth and Changes in the National Health Service Corps (NHSC) Workforce with the American Recovery and Reinvestment Act

Background: From March 2009 through February 2011, the National Health Service Corps (NHSC) received a $300 million supplement through the American Recovery and Reinvestment Act to grant more loan repayment awards to clinicians who agree to work in underserved areas. This study assesses how this unprecedented funding increase affected the size, composition, and location of the NHSC's workforce. Methods: This was a descriptive, time-linked, observational study using NHSC administrative data. Main outcomes were growth and changes in disciplinary composition of the NHSC's workforce and in its rural/urban and state-to-state distribution. Results: During the Recovery Act period, the NHSC's workforce increased by 156%, from 3017 to 7713 clinicians. Mental health clinicians grew most numerically (210%) and as a proportion of the NHSC's workforce (from 22.7% to 27.4%). Primary care clinicians grew least and decreased as a proportion of the NHSC's workforce to 58.9%; dental health clinicians remained steady at approximately 13.5%. Among individual disciplines, physicians decreased most as a component of the NHSC's overall workforce, from 38.6% to 26.7%, whereas the proportion of nurse practitioners grew most, from 10.1% to 16.0%. Proportions of the NHSC's workforce serving in rural areas changed only modestly. NHSC clinician numbers grew most in states with the lowest NHSC clinician-to-poverty population ratios before the Recovery Act. Conclusions: With Recovery Act funding, the NHSC's workforce become far larger and more diverse than ever and more evenly distributed across states. The NHSC should now set targets and be more deliberate in managing its growth across disciplines and where its clinicians serve.
Human Moving Pattern Recognition toward Channel Number Reduction Based on Multipressure Sensor Network

A pair of sensing shoes for measuring foot pressure was developed. This system aims at recognizing human movement in unlimited environments. The multipressure sensor network of seven sensors on one insole was set up. Analysis for discriminating the user's movements from foot pressure distribution was carried out, considering the movements of standing, walking, going upstairs, and going downstairs. These actions were discriminated using characteristics extracted from the data of sensors. The classifier based on SVM showed highly accurate movement recognition. Specifically, to improve the classification performance, PCA based dimensionality reduction and channel reduction based data fusion were introduced. Experimental outcomes verified the testing speed of the classification function which was improved without affecting the accuracy rate. The results confirmed that this discriminant analysis can be employed for automatically recognizing human moving pattern based on foot pressure signal.
Researchers spy signs of slavery from space.

Doreen Boyd remembers the first time she saw a hint of slavery from space. A satellite image from 2017 of the state of Rajasthan in India showed a brown oval that looked like a dusty high school track. But it was nothing so innocuous: She knew it was a brick kiln, one of tens of thousands across South Asia that are often run on forced labor. Boyd, director of the data program at the Rights Lab at the University of Nottingham in the United Kingdom, realized such imagery could help her tally the kilns, enabling organizations on the ground to target slaveholders at the sites. "You can9t see slavery directly, but you can infer it," she says. A surge in the number of Earth-observing satellites, along with improvements in algorithms that can interpret the deluge of data they provide, are putting modern slavery under a spotlight. This week, at a conference in New York City sponsored by the United Nations University, computer scientists, slavery experts, and policy strategists presented the latest efforts in their fields and brainstormed ways to work together. Some 40.3 million people are held in bondage today, according to the latest estimates. But finding them is hard. Boyd estimates, however, that one-third of all slavery is visible from space, whether in the scars of kilns or illegal mines or the outlines of transient fish-processing camps.
Electrical stimulation for limb spasticity in children with traumatic brain injury

Background: Previous clinical studies have reported that electrical stimulation (ES) can be utilized to treat children with limbs spasticity (LS) after traumatic brain injury (TBI). Currently, no systematic review has addressed the effect of ES in children with LS following TBI. Thus, this systematic review will assess the effect and safety of ES for the children with LS after TBI. Methods: We will conduct the present systematic review of randomized controlled trials that will be retrieved from searches of PubMed, PsycINFO, WOS, Scopus, OpenGrey, Google Scholar, Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, and Chinese Biomedical Literature Database from the inception to the date of the literature searched. In addition, the clinical register websites, and reference lists of relevant studies will also be searched. Two independent reviewers will evaluate the eligibility criteria for all papers, extract the data and determine the methodology quality by using Cochrane risk of bias tool. Results: The results of this systematic review will pool the latest available data, and are expected to provide the summary of present evidence of ES for children with LS following TBI. Timeline: This systematic review will start on January 10, 2019 and expected to complete by June 1, 2019. Ethics and dissemination: No research ethic approval is needed in this study, because the data of this systematic review will not base on the individual data level. The results will be disseminated to publish at peer-reviewed journals or will present at relevant conferences. PROSPERO registration number: CRD42019120037
Protocol for a prospective, longitudinal, cohort study of recovery pathways, acute biomarkers and cost for children with persistent postconcussion symptoms: the Take CARe Biomarkers study

Introduction The majority of children who sustain a concussion will recover quickly, but a significant minority will experience ongoing postconcussive symptoms, known as postconcussion syndrome (PCS). These symptoms include emotional, behavioural, cognitive and physical symptoms and can lead to considerable disability. The neurobiological underpinnings of PCS are poorly understood, limiting potential clinical interventions. As such, patients and families frequently re-present to clinical services, who are often ill equipped to address the multifactorial nature of PCS. This contributes to the high cost of concussion management and the disability of children experiencing PCS. The aims of the present study are: (1) to plot and contrast recovery pathways for children with concussion from time of injury to 3 months postinjury, (ii) evaluate the contribution of acute biomarkers (ie, blood, MRI) to delayed recovery postconcussion and (3) estimate financial costs of child concussion to patients attending the emergency department (ED) of a tertiary children’s hospital and factors predicting high cost. Methods and analysis Take C.A. Re is a prospective, longitudinal study at a tertiary children’s hospital, recruiting and assessing 525 patients aged 5–<18 years (400 concussion, 125 orthopaedic injury) who present to the ED with a concussion and following them at 1–4 days, 2 weeks, 1 month and 3 months postinjury. Multiple domains are assessed: preinjury and postinjury, clinical, MRI, blood samples, neuropsychological, psychological and economic. PCS is defined as the presence of ≥2 symptoms on the Post Concussive Symptoms Inventory rated as worse compared with baseline 1 month postinjury. Main analyses comprise longitudinal Generalised Estimating Equation models and regression analyses of predictors of recovery and factors predicting high economic costs. Ethics and dissemination Ethical approval has been obtained through the Royal Children’s Hospital Melbourne Human Research Ethics Committee (33122). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media. Trial registration number ACTRN12615000316505; Results.
Clopidogrel response status assessed with Multiplate point-of-care analysis and the incidence and timing of stent thrombosis over six months following coronary stenting

Summary Clopidogrel low-responsiveness assessed with multiple electrode platelet aggregometry (MEA) has been shown to be a strong and independent predictor of early stent thrombosis (ST) after coronary stenting. The relation of clopidogrel response status, as assessed with MEA, with incidence and timing of ST during an extended follow-up period has never been reported. Here, we report the six-month follow-up results of a prospective trial assessing clopidogrel responsiveness with MEA in patients undergoing percutaneous coronary intervention (PCI). A total of 1,608 consecutive patients with planned drug-eluting stent placement were enrolled in this study. Before PCI patients uniformly received 600 mg clopidogrel and blood was taken directly before PCI to measure ADP-induced platelet aggregation with MEA. The upper quin-tile (20%) of patients according to MEA measurements (n=323) was defined as clopidogrel low responders. Compared with normal responders (n=1,285), the cumulative incidence of definite ST within six months was significantly higher in low responders [2.5% vs. 0.4%; OR 6.5; 95% CI, 2.4–17.0; P<0.001]. The combined incidence of definite or probable ST was higher as well in low vs. normal responders [4.1% vs. 0.7%; OR 5.8; 95% CI, 2.8–12.3; P<0.0001]. A significant inverse correlation of MEA values and the timing of definite or probable ST (in days) was observed (Spearman coefficient = –0.45; P=0.04) with events occurring earlier in the low-responder group. MEA measurements are highly predictive for the occurrence of ST during the first six months following coronary stenting. In the majority of clopidogrel low responders suffering ST, the ischaemic event occurs early in the course after the procedure.
High Signal Intensity in Globus Pallidus and Dentate Nucleus on Unenhanced T1-weighted MR Images: Evaluation of Two Linear Gadolinium-based Contrast Agents.

PURPOSE To determine if a correlation exists between the number of previous enhanced magnetic resonance (MR) imaging examinations and high signal intensity in the globus pallidus (GP) and dentate nucleus (DN) in patients who received gadodiamide (Omniscan), a linear nonionic gadolinium-based contrast agent, and in those who received gadobenate dimeglumine (MultiHance), a linear ionic contrast agent. MATERIALS AND METHODS Institutional review board approval was obtained for this single-center retrospective study, with waiver of informed consent. The study population included 69 patients divided into two groups: Group 1 included patients who underwent gadodiamide-enhanced MR imaging, and group 2 included patients who underwent gadobenate dimeglumine-enhanced MR imaging. Two radiologists conducted a quantitative analysis of unenhanced T1-weighted images by using region of interest measurements. The GP-to-thalamus (TH) signal intensity ratio, DN-to-middle cerebellar peduncle (MCP) signal intensity ratio and relative percentage change (Rchange) between the first and last examinations for each patient were calculated. Relation between the signal intensity ratios and Rchange and the number of enhanced MR imaging examinations was analyzed by using a generalized additive model. Inter- and intraobserver agreement was evaluated with the Lin concordance correlation coefficient test. RESULTS Group 1 included 23 patients (19 female), with a mean of 5.0 doses ± 2.4 (standard deviation) (range, 3-11 doses) administered. Group 2 included 46 patients (24 female) with a mean of 4.6 doses ± 2.2 (range, 3-11 doses) administered. The interval between the first and last examination was 1500.1 days ± 780.2 (range, 98-3097 days) for group 1 and 1086.2 days ± 582.9 (range, 94-2633) for group 2. All patients had normal liver and renal function. Gadodiamide showed a significant increase in DN:MCP and GP:TH (P < .001 for both) and in Rchange (P = .001 for GP:TH, P < .001 for DN:MCP). In group 2, there was no significant increase in DN:MCP or GP:TH over time or in Rchange for GP:TH, but there was a significant trend toward an increase in Rchange for DN:MCP (P = .013). Interobserver agreement was almost perfect (0.99; 95% confidence interval: 0.99, 0.99) for all evaluated structures. Intraobserver agreement was substantial to almost perfect for both readers. CONCLUSION A significant increase in GP:TH and DN:MCP is associated with multiple gadodiamide-enhanced studies but not with gadobenate dimeglumine-enhanced studies, likely reflecting differences in stability and elimination of both contrast agents. Rate-of-change data indirectly suggest gadolinium deposition in the DN with gadobenate dimeglumine use, although it is considerably less than that with gadodiamide use.
Differential Recognition of Vibrio parahaemolyticus OmpU by Toll-Like Receptors in Monocytes and Macrophages for the Induction of Proinflammatory Responses

Vibrio parahaemolyticus is a human pathogen, and it is a major cause of severe gastroenteritis in coastal areas. OmpU is one of the major outer membrane porins of V. parahaemolyticus. ABSTRACT Vibrio parahaemolyticus is a human pathogen, and it is a major cause of severe gastroenteritis in coastal areas. OmpU is one of the major outer membrane porins of V. parahaemolyticus. Host-immunomodulatory effects of V. parahaemolyticus OmpU (VpOmpU) have not been elucidated yet. In this study, in an effort towards characterizing the effect of VpOmpU on innate immune responses of the host, we observed that VpOmpU is recognized by the Toll-like receptor 1/2 (TLR1/2) heterodimer in THP-1 monocytes but by both TLR1/2 and TLR2/6 heterodimers in RAW 264.7 macrophages. To the best of our knowledge, this is the first report of a natural pathogen-associated molecular pattern (PAMP) recognized by both TLR1/2 and TLR2/6 heterodimers; so far, mainly the synthetic ligand Pam2CSK4 has been known to be recognized by both the TLR1/2 and TLR2/6 heterodimers. We also have shown that VpOmpU can activate monocytes and macrophages, leading to the generation of proinflammatory responses as indicated by tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and NO production in macrophages and TNF-α and IL-6 production in monocytes. VpOmpU-mediated proinflammatory responses involve MyD88-IRAK-1 leading to the activation of mitogen-activated protein (MAP) kinases (p38 and Jun N-terminal protein kinase [JNK]) and transcription factors NF-κB and AP-1. Further, we have shown that for the activation of macrophages leading to the proinflammatory responses, the TLR2/6 heterodimer is preferred over the TLR1/2 heterodimer. We have also shown that MAP kinase activation is TLR2 mediated.
The validity and reliability of the Basketball Jump Shooting Accuracy Test

ABSTRACT The aim of this study was to examine the content validity, construct validity and reliability of the newly developed Basketball Jump Shooting Accuracy Test (BJSAT). Basketball athletes from different playing levels (State Basketball League [SBL], n = 30, age: 22.7 ± 6.1 yr; SBL Division I, n = 11, age: 20.6 ± 2.1 yr) completed four separate trials of the BJSAT with each trial consisting of shot attempts from two- and three-point distances at pre-determined court locations. Each shot attempt was scored utilising a criteria where higher scores were given when greater accuracy was exhibited. The BJSAT detected a significant, large difference in accuracy between two- and three-point shots (d = 0.99, p < 0.01). Relative reliability across the repeated trials was rated as moderate for all athletes (intraclass correlation coefficient [ICC] = 0.71, p < 0.01) and good for the SBL athletes (ICC = 0.78, p < 0.01). Absolute reliability for all athletes was above the acceptable benchmark (coefficient of variation = 16.2%); however superior to skill tests available in the literature. In conclusion, the BJSAT is sensitive to two- and three-point shooting accuracy and can reliably assess jump shooting accuracy in basketball athletes.
Use of high intensity adjusted dose low molecular weight heparin in women with mechanical heart valves during pregnancy: a single-center experience

This report describes the successful use of dose-escalating low molecular weight heparin thrombo-profylaxis in pregnant women with prosthetic heart valves. The use of standard dose low molecular weight heparin (LMWH) to anticoagulate women with mechanical valves in pregnancy is associated with morbidity and mortality. We conducted a prospective audit of the use of adjusted dose high intensity LMWH in 12 pregnancies in 11 women with prosthetic heart valves. LMWH ± low-dose aspirin was started at therapeutic-dose with monitoring of anti-Xa levels to achieve a target level of 1.0–1.2 IU/mL (0.8–1.2 in the first 3/12 pregnancies). This necessitated a mean increase in the dose of LMWH of 54.4% (SD±33.2) over initial dose. Eleven of 12 pregnancies resulted in live births, with one intrauterine fetal death at 37 weeks. One non-fatal valve thrombosis occurred at 26 weeks gestation associated with subtherapeutic anti-Xa levels. Three patients experienced major bleeding. This regime provides a therapeutic option for women with mechanical heart valves during pregnancy, provided anti-Xa levels are kept within the target range. These patients require close surveillance for bleeding and thrombotic complications within a multi-disciplinary setting.
Development and Characterization of Chitosan Microparticles-in-Films for Buccal Delivery of Bioactive Peptides

Nowadays, bioactive peptides are used for therapeutic applications and the selection of a carrier to deliver them is very important to increase the efficiency, absorption, release, bioavailability and consumer acceptance. The aim of this study was to develop and characterize chitosan-based films loaded with chitosan microparticles containing a bioactive peptide (sequence: KGYGGVSLPEW) with antihypertensive properties. Films were prepared by the solvent casting method, while the microparticles were prepared by ionic gelation. The final optimized chitosan microparticles exhibited a mean diameter of 2.5 µm, a polydispersity index of 0.46, a zeta potential of +61 mV and a peptide association efficiency of 76%. Chitosan films were optimized achieving the final formulation of 0.79% (w/v) of chitosan, 6.74% (w/v) of sorbitol and 0.82% (w/v) of citric acid. These thin (±0.100 mm) and transparent films demonstrated good performance in terms of mechanical and biological properties. The oral films developed were flexible, elastic, easy to handle and exhibited rapid disintegration (30 s) and an erosion behavior of 20% when they came into contact with saliva solution. The cell viability (75–99%) was proved by methylthiazolydiphenyl-tetrazolium bromide (MTT) assay with TR146 cells. The chitosan mucoadhesive films loaded with peptide–chitosan microparticles resulted in an innovative approach to perform administration across the buccal mucosa, because these films present a larger surface area, leading to the rapid disintegration and release of the antihypertensive peptide under controlled conditions in the buccal cavity, thus promoting bioavailability.
Climate change, uncertainty and allostatic load

Abstract Context: Humans constantly respond to environmental stressors challenging their somatic stability. Allostasis, an evolved neuroendocrine/physiological stressor response system, is our main pathway for doing so. Effective allostasis returns somatic systems to their current optima; over a lifetime of stressor responses, related systems fail, effectiveness declines, and physiological dysregulation (i.e. allostatic load) increases. Global Climate Change (GCC) multiplies environmental stressors on human populations and is likely to increase allostatic load. Objectives: As a population-level stressor, GCC increases risks for multiple stressors, including sociocultural instability and food and water insecurity, while also motivating migration. We predict GCC increases risk for elevated allostatic load. Here, we review pathways by which GCC increases climatic and social stressors contributing to greater stress and allostatic load. Methods: Based upon published sources and primary ethnographic case studies, this review examines how GCC, by multiplying climate-related stressors, likely increases social instability, food and water insecurity, and migration. Thereby, it is proposed that GCC contributes to allostatic load. Results: GCC multiplies stressors on local populations. Those experiencing social insecurity related to GCC during growth and development are expected to show the largest influences on their lifetime allostatic load. Similarly, as GCC increases food and water insecurity, it likely will increase allostatic load in those affected and is likely to propel migrants to seek improved living circumstances. These stressors may be continued among their descendants via historical trauma or epigenetic responses. Conclusion: GCC accentuates effects of environmental and sociocultural stressors on human populations. Those exposed to GCC are likely to show lifelong elevated allostatic load.
Assessing discrepancies in outcomes of pain rehabilitation: “these questionnaires don’t measure results that are relevant to me”

Abstract Background: Pain rehabilitation programs are recommended interventions for patients with chronic pain. Average effect sizes are moderate. Physiatrists, based on clinical experience, argue that the present outcome measures underestimate the outcome of pain rehabilitation programs. Objective: (1) To explore discrepancies and relationships in outcomes of pain rehabilitation. (2) To explore causes of discrepancies from the perspective of patients. Method: A mixed-method, prospective cohort study of patients who participated in pain rehabilitation programs. Outcome measures: Canadian Occupational Performance Measure, Pain Disability Index, a discharge assessment by the physiatrist. Differences and relations were tested. Semi-structured interviews about patients' explanations for discrepancy were performed via telephone. Results: Outcomes of 45/80 patients (56%) were discrepant. When discrepant, effect sizes of the Canadian Occupational Performance Measure and the Pain Disability Index were substantially lower, but the physiatrist-rated outcomes did not differ between discrepant and non-discrepant patients. Common patient-reported explanations for discrepancy were improvement of coping skills and irrelevant (items of) questionnaires. Conclusion: Discrepancies occurred often. When discrepant, physiatrist-rated outcome reflects a more positive outcome compared to the other outcome measures. The results of the interviews suggest that the present outcome measures may not fully capture life domains that are relevant for patients, and may thus underestimate meaningful outcomes. IMPLICATIONS FOR REHABILITATION Present standardized outcome measures may not fully capture and may underestimate meaningful outcomes of pain rehabilitation. Outcome measures of pain rehabilitation programs should include a meaningful patient-centered measure. Development of a patient-centered instrument to capture meaningful outcomes of pain rehabilitation is needed.