Miracle-dz/UniFAR-FTUs huggingface dataset:
Family practice providers’ perspectives on clinical practice guidelines and recommendations for Hepatitis C screening of baby boomers

Background: Clinical Practice guidelines (CPGs) are developed to guide clinical decisions. CPG adoption varies by provider and practice setting. In 2012 and 2013 U.S. preventive care organizations expanded hepatitis C virus (HCV) screening CPGs to include screening of those born between 1945 and 1965. This qualitative study examined the adoption of CPGs generally and of the HCV screening CPG among a group of family practice providers. Methods: Individual, semi-structured interviews with 31 family practice providers (12 medical residents, 18 attending physicians, and 1 advanced practice nurse) at community-based family medicine practices were completed in 2016. Questions considered knowledge and beliefs about CPGs (in general and the expanded HCV guidelines in particular) and self-assessed HCV screening rates. Three researchers independently, then collectively, reviewed interview transcripts to identify common and emergent themes. Results: All subjects viewed CPGs as useful tools and reported prioritization of CPGs and delivery of preventive services. Prioritization was influenced by awareness, knowledge, CPG source, agreement among professional organizations, time constraints, perceived importance of the health condition, and difficulty of implementation. Generally, awareness of CPGs occurs informally through conversation or independent reading, though some formal or systematic means are used. Smart tools which prompt action at point of care were used by a few subjects and were deemed likely to improve practice. Awareness of the expanded HCV screening guideline varied by position although knowledge of guideline details was limited. Most subjects considered their patients to be of low-risk for HCV infection and estimates of HCV screening rates were low (2-25%). Conclusion: Preventive practice guidelines are well accepted, but implementation varies. Knowledge of and attitudes about age-based HCV screening guidelines is low and lack of reminders at point-of-care limit screening initiation. Improved education and systems-based approaches to improve screening practices are essential to reap benefits of expanded guidelines. *Correspondence to: Amy B Jessop, Director, HepTREC, 141 Whitemarsh Rd, Ardmore, PA 19003, USA, Tel: 610-220-7473; Fax: 610-642-8190; E-mail: amy.jessop@heptrec.org
The Development and Impact of Clinical Skills Handbooks in Undergraduate Medical Education

Introduction: Traditional teaching of clinical skills in medical school commonly entails didactic teaching followed by practice sessions with Standardized Patients (SPs) for particular skills, such as the cardiovascular exam. To address the need for briefer and more concise reference guides from standard textbooks and to consolidate skills expectations, the University of Ottawa developed clinical skills handbooks for students. The purpose of this study was to evaluate students’ use of these handbooks in the pre-clinical and clinical years. Methods: We distributed a survey to second, third, and fourth year medical students at the University of Ottawa from November 2016 to January 2017. The survey assessed how frequently students used the booklets and their opinions on the usefulness of the booklets as a learning tool. Results: There were 121 respondents of 492 students eligible for the survey. Of the respondents, 96.7% claimed to have used the booklets, and 75% claimed it was their primary resource for physical exam skills education. The majority of pre-clinical students used the booklets when learning a physical exam – 65% almost always, and 97% at least sometimes. The majority of clinical students (also referred to as clerkship students) used the booklets when reviewing a physical exam – 25% almost always, and 64% at least sometimes. Most students used the booklets when studying for OSCEs – 65% almost always, and 94% at least sometimes. Conclusions: Students at the University of Ottawa found the clinical skills handbooks to be a valuable resource during their medical training and for the majority, it was their most commonly used reference. These findings support the need for further development and use of these resources.
Strategies of Multi-Step-ahead Forecasting for Blood Glucose Level using LSTM Neural Networks: A Comparative Study

: Predicting the blood glucose level (BGL) is crucial for self-management of Diabetes. In general, a BGL prediction is done based on the previous measurements of BGL, which can be taken either (manually) by using sticks or (automatically) by using continuous glucose monitoring (CGM) devices. To allow the diabetic patients to take appropriate actions, the BGL predictions should be done ahead of time; thus a multi-step ahead prediction is suitable. Therefore, many Multi-Step-ahead Forecasting (MSF) strategies have been developed and evaluated, and can be categorized in five types: Recursive, Direct, MIMO (for Multiple Input Multiple Output), DirMO (combining Direct and MIMO) and DirRec (combining Direct and Recursive). However, none of them is known to be the best strategy in all contexts. The present study aims at: 1) reviewing the MSF strategies, and 2) determining the best strategy to fit with a LSTM Neural Network model. Hence, we evaluated and compared in terms of two performance criteria: Root-Mean-Square Error (RMSE) and Mean Absolute Error (MAE), the five MSF strategies using a LSTM Neural Network with an horizon of 30 minutes. The results show that there is no strategy that significantly outperformed others when using the Wilcoxon statistical test. However, when using the Sum Ranking Differences method, MIMO is the best strategy for both RMSE and MAE criteria.
Mood, Location and Physical Position as Predictors of Ambulatory Blood Pressure and Heart Rate: Application of a Multi-Level Random Effects Model

Despite the popularity of ambulatory blood pressure monitoring (ABPM) in behavioral research and the interest in the role of negative affect in cardiovascular disease, few studies have examined the prevalence and cardiovascular effects of mood states on blood pressure (BP) and heart rate during everyday life. Those that have done this have used suboptimal analytic techniques. The present analysis is based on 24-hour ambulatory blood pressure (ABP) readings from 246 normotensive subjects who are part of an ongoing worksite study. Subjects were asked to report their position, location, activity, mood, and social interaction at the time of each BP reading. The data are analyzed by a multilevel random effects model based on a repeated measures ANO VA. The initial analysis evaluates the effects of position (standing, sitting, reclining) and location (home, work, other). The BP changes associated with position are relatively large (8–12 mm Hg) and stable across individuals, while those for location are modest (2–4 mm Hg) and show considerable inter-subject variation. Subjects were asked to record one or more of twelve mood states; 65% of readings were reported as “neutral,” 12% as “happy,” 7% as “anxious,” 6% as “tired,” and less than 1% as “angry. ” After controlling for position, location, and significant moods, significant increases of both systolic and diastolic BP were observed for “angry” (4/4 mm Hg systolic/diastolic BP), “excited” (3/2 mm Hg), and “happy” (1/1 mm Hg). Significant decreases of both BPs were observed for “tired” (−2/−1 mm Hg). Heart rate changes were generally inconsistent, except for an increase associated with feeling “rushed” (1 bpm). We conclude that while position and location account for a substantial part of the overall BP and heart rate variance, the effects of position are greater than would be expected on purely hemodynamic grounds and may be attributed to unreported differences in the level of arousal. Anger was the least regularly reported mood but is associated with the largest increase of BP. In total, mood does not account for much of the variance in BP or heart rate.
Estimating Determinants of Attrition in Eating Disorder Communities on Twitter: An Instrumental Variables Approach

Background The use of social media as a key health information source has increased steadily among people affected by eating disorders (EDs). Research has examined characteristics of individuals engaging in online communities, whereas little is known about discontinuation of engagement and the phenomenon of participants dropping out of these communities. Objective This study aimed to investigate the characteristics of dropout behaviors among eating disordered individuals on Twitter and to estimate the causal effects of personal emotions and social networks on dropout behaviors. Methods Using a snowball sampling method, we collected a set of individuals who self-identified with EDs in their Twitter profile descriptions, as well as their tweets and social networks, leading to 241,243,043 tweets from 208,063 users. Individuals’ emotions are measured from their language use in tweets using an automatic sentiment analysis tool, and network centralities are measured from users’ following networks. Dropout statuses of users are observed in a follow-up period 1.5 years later (from February 11, 2016 to August 17, 2017). Linear and survival regression instrumental variables models are used to estimate the effects of emotions and network centrality on dropout behaviors. The average levels of attributes among an individual’s followees (ie, people who are followed by the individual) are used as instruments for the individual’s attributes. Results Eating disordered users have relatively short periods of activity on Twitter with one half of our sample dropping out at 6 months after account creation. Active users show more negative emotions and higher network centralities than dropped-out users. Active users tend to connect to other active users, whereas dropped-out users tend to cluster together. Estimation results suggest that users’ emotions and network centralities have causal effects on their dropout behaviors on Twitter. More specifically, users with positive emotions are more likely to drop out and have shorter lasting periods of activity online than users with negative emotions, whereas central users in a social network have longer lasting participation than peripheral users. Findings on users’ tweeting interests further show that users who attempt to recover from EDs are more likely to drop out than those who promote EDs as a lifestyle choice. Conclusions Presence in online communities is strongly determined by the individual’s emotions and social networks, suggesting that studies analyzing and trying to draw condition and population characteristics through online health communities are likely to be biased. Future research needs to examine in more detail the links between individual characteristics and participation patterns if better understanding of the entire population is to be achieved. At the same time, such attrition dynamics need to be acknowledged and controlled when designing online interventions so as to accurately capture their intended populations.
Restarted primal–dual Newton conjugate gradient method for enhanced spatial resolution of reconstructed cone-beam x-ray luminescence computed tomography images

Cone-beam x-ray luminescence computed tomography (CB-XLCT) has been proposed as a promising imaging tool, which enables three-dimensional imaging of the distribution of nanophosphors (NPs) in small animals. However, the reconstruction performance is usually unsatisfactory in terms of spatial resolution due to the ill-posedness of the CB-XLCT inverse problem. To alleviate this problem and to achieve high spatial resolution, a reconstruction method consisting of inner and outer iterations based on a restarted strategy is proposed. In this method, the primal–dual Newton conjugate gradient method (pdNCG) is adopted in the inner iterations to get fast reconstruction, which is used for resetting the permission region and increasing the convergence speed of the outer iteration. To assess the performance of the method, both numerical simulation and physical phantom experiments were conducted with a CB-XLCT system. The results demonstrate that compared with conventional reconstruction methods, the proposed re-pdNCG method can accurately and efficiently resolve the adjacent NPs with the least relative error.
Neurosurgical Treatments of Neurodegenerative Disorders

Functional neurosurgery consists of procedures that either promotes judicious destruction or chronic stimulation of the nervous system in order to treat disordered behavior or aberrant function, as it is expected in neurodegenerative disorders ([NDs], e.g., movement disorders [Parkinson's disease, Tourette's syndrome, essential tremor, ballism, and dystonia]). Over the past 20 years, approximately 100,000 deep brain stimulation implant procedures have been performed worldwide. Neurosurgery is also a well-established therapeutic option for people with epilepsy whose seizures are not controlled by anti-epilepsy drugs. The most common pathological finding in patients with drug-resistant mesial temporal lobe epilepsy is hippocampal sclerosis. The aim of this chapter is to present the main NDs that can be treated through surgical procedures, and to describe the surgeries with a focus on the pathophysiology of diseases.
The formulation of guidelines for an occupational health and safety program to address women’s health concerns of mineworkers at a selected coalmine in Mpumalanga South Africa

ion Abstraction is referred to as the formulation of a general description of the research topic through generating categories (Burnard 1996; Polit & Beck 2014). Each category was named using content-characteristic words. The researcher grouped subcategories with similar events and incidents together as categories and categories were grouped as main categories (Kyngäs & Vanhanen 1999:7). The abstraction process continued as far as was reasonable and possible.ion is referred to as the formulation of a general description of the research topic through generating categories (Burnard 1996; Polit & Beck 2014). Each category was named using content-characteristic words. The researcher grouped subcategories with similar events and incidents together as categories and categories were grouped as main categories (Kyngäs & Vanhanen 1999:7). The abstraction process continued as far as was reasonable and possible. Step 3: Reporting and analysing process and the results The analysis process and the results were described in as much detail as possible so that another reader could have a clear understanding of how the analysis was carried out and its strengths and limitations (Patton 2002:504). This contributed to the content validity. The results were described in categories; the content of the categories was described through subcategories. For the content analysis to succeed, the researcher analysed and simplified the data and formed categories that reflected women’s health concerns in a reliable manner (Kyngäs & Vanhanen 1999:8) and thereby enhancing the validity of the results (Graneheim & Lundman 2004:109). For this study to have an ultimate product of academic research, the researcher comprehensively monitored and reported the analytical processes (Patton 2003:110). Furthermore, the researcher believed that the decisions and processes regarding coding approach and techniques were utilised to establish the trustworthiness of the study. Figure 3 below represents the data analysis process.
Molecular detection of canine respiratory pathogens between 2017 and 2018 in Japan

A molecular survey was conducted to understand recent distribution of pathogens associated with canine infectious respiratory disease (CIRD) in Japan. Nasal and/or pharyngeal swabs were collected from asymptomatic dogs and those with CIRD, living in private house or in kennels. PCR-based examination was conducted for detecting nine pathogens. Among private household dogs, 50.8% with CIRD, 11.1% with respiratory disease other than CIRD, and 4.3% asymptomatic were positive for more than one pathogen, whereas in kennel-housed dogs, 42.9% with CIRD and 27.3% asymptomatic were positive. Bordetella bronchiseptica was most frequently detected, followed by canine herpesvirus 1, canine parainfluenza virus, canine pneumovirus, Mycoplasma cynos, and canine adenovirus type 2. In kennel environment, asymptomatic dogs might act as reservoirs carrying the respiratory pathogens.
The chemokine receptors XCR1, CXCR1 and CXCR2 regulate oral epithelial cell behaviour

Chemokines are chemoattractant cytokines which act on specific receptors and play an important role in tumour biology. The aim of this project was to determine whether the chemokine receptors XCRl, CXCRl and CXCR2 and their respective ligands lymphotactin, IL-8 (CXCRl&2) and GRO-a regulate the behaviour of normal and malignant oral epithelial cells. XCRl, CXCRl and CXCR2 mRNA and surface protein expression was detected in normal and oral cancer cell lines. Lymphotactin, IL-8 and GRO-a facilitated intracellular activation of ERK1/2 signaling pathway and stimulated migration, invasion and proliferation of all cells. These effects were mediated through XCRl for lymphotactin, CXCRl and CXCR2 for IL-8 and CXCR2 for GRO-a. The cancer cells showed a greater response than normal cells and a direct relationship between receptor expression and migration, invasion and proliferation was observed. XCRl but not lymphotactin was expressed by epithelial cells in normal oral mucosa in vivo and both were expressed and upregulated in inflammation and cancer. Constitutive expression of both XCRl and lymphotactin was found in regional lymph nodes and on metastatic tumours. Lymphotactin mRNA al}d constitutive intracellular protein was detected in normal and cancerous oral cells. Exposure of normal cells to lymphotactin resulted in increased adhesion to fibronectin but not collagen and stimulated MMP-2 and -9 release whereas exposure of cancer cells resulted in increased adhesion to both collagen and fibronectin and stimulated MMP-2, 9 and MMP-7 release. These findings show for the first time that XCRl and its ligand lymphotactin are expressed by epithelial cells in a range of oral conditions and strongly suggest that they play an important role in regulating the behaviour of normal and malignant epithelial cells. Similarly CXCRl and CXCR2 are upregulated on malignant oral cells in vitro and may be important in the biology of oral cancer.
Die Porphyrkuppenlandschaft des unteren Saaletals - Strukturwandel ihrer Vegetation in den letzten vier Jahrzenten.

The landscape of porphyry outcrops in the lower Saale-valley Structural change of vegetation in the last four decades The vegetation cover of the fragmented porphyry outcrops in the lower valley of the river Saale near Halle was investigated in 1992-1996. All together, 50 plant communities have been described, 13 of them mainly forming the vegetation mosaic of the porphyry landscape. The survey includes the typical nearly natural xerothermic grassland communities (Sedo-Scleran th etalia , Festuco-Sedetalia , Festucetalia valesiacae), the dwarf-shrub heaths (V accin io-G enistetalia), as well as the more anthropo-zoogenically influenced plant communities (A gropyretalia repentis, A rrh en ath ereta lia elatioris, S isym brietalia o ffi­ cinalis). For the valuable dry and semi-dry grasslands and the dwarf-shrub heaths we used relevés from MAHN (1965) and SCHUBERT (1960) to evaluate the change in vegetation structure over the last four decades. Climatic change as well as global and local atmospheric nitrogen deposition are chiefly seen to be responsible for the change of the vegetation cover in different habitats. In the areas investigated we observed an increasing number of species, especially ruderal ones, over the last four decades. Neverthe­ less the immigrants mostly showed a very low density of individuals, so that they are not yet endange­ ring the most important xerothermic communities. A reason is the relative high stability of the environ­ mental conditions. Diese Arbeit über eines seiner langjährigen Forschungsgebiete sei Herrn Prof. Dr. E. -G. MAHN zu seinem 70. Geburtstag in Dankbarkeit gewidmet.
Dietary intake of food bioactives in a cohort of European adults with metabolic syndrome enrolled in the Pathway-27 trial

Metabolic syndrome (MetS) is the name given to a cluster of conditions that occur together more often than can be explained by chance. It is estimated that 20 – 25 % of the global adult population have MetS (1) and are three times as likely to suffer a heart attack or stroke and have a ﬁ vefold greater risk of developing type-2 diabetes compared with people who do not have MetS (2 – 3) . The PATHWAY-27 project evaluated the effectiveness of bioactive enriched food (BEF) on improving risk factors of MetS in participants at risk, or with, MetS. Following ethical approval, the trial was registered on clinicaltrials.gov (trial # NCT02702713). The bioactive compounds selected were docosahexaenoic acid (DHA), oat beta-glucan (OBG) and grape anthocyanins (AC). In a multi-centre, randomized, double-blind, nutritional intervention trial, 251 human volunteers were recruited to consume BEF for 12 weeks. Metabolic and anthropometric markers were measured at 0, 6 and 12 weeks. Dietary exposure to DHA, OBG and AC from the participants ’ typical diet was assessed at baseline using a food frequency questionnaire. Participants were asked to estimate the frequency of consumption and portion size of foods known to contain each bioactive over 6-weeks prior to the start of the trial. Bioactive com-position information was derived from national and international databases (EuroFIR; Polyphenol Explorer), literature information and direct analysis of foods. A deterministic exposure analysis was used to calculate dietary exposure for each participant enrolled in the trial according to equation (1) where E = exposure of individual (j); n = number of portions on day (k) of food commodity (l), w = portion of food, c = concentration of bioactive.
Serum calcium as a severity marker in acute ischemic stroke

Introduction: Stroke is the second most common cause for increasing mortality worldwide. Calcium is known to be major mediator in ischemic neuronal cell death. Recent studies have shown that elevated serum calcium levels at admission in patients with stroke have been associated with less severe clinical deficits and with better outcomes. With this as a background, there is a need to develop reliable and viable prognostic markers that remains an important goal in the field of medical research. Aims & objectives: To determine the serum calcium as a prognostic marker in acute ischemic stroke and correlate serum calcium with NIHSS to look for prognosis. Methodology: A hospital based cross sectional study was done during April – September 2017 in Government Stanley medical college and hospital, Chennai. The total sample taken was 75 and the samples are selected based on simple random sampling. Structured questionnaire was used. Data collected entered in MS-EXCEL and analyzed using SPSS version 21.Results interpreted. Results: 60% of the patients with stroke had low serum calcium, among which 55.6% belong to 61-70 years, 53.3% were of male gender, 44.4% alcoholic, 42.4% smoker, 53.3% were diabetic and 57.8% were hypertensives, 95.6% had speech disturbances. Significant association was noted between serum calcium level with the risk factors such as diabetes and hypertension, age and gender (p-<0.05). Pearson’s coefficient was statistically significant when serum calcium is correlated with NIHSS and MRS using ANOVA.