Miracle-dz/UniFAR-FTUs huggingface dataset:
Depression assessment: Spouses are poor proxies for cardiovascular disease patients

Background: Patients are frequently assisted by proxies, usually a spouse, to complete health and medical surveys, including depression assessments. Objective: The objective of this study was to examine whether spousal assessments of patient depression concord with those of the patient. Materials and Methods: Consecutive adult cardiac patients attending an outpatient cardiovascular disease clinic accompanied by an adult were enrolled. Patient–spousal pairs independently completed the Cardiac Depression Scale (CDS) on behalf of the patient. Proxies provided demographic and medical history information and also completed the Physical Health Questionnaire. Results: A total of 72 patients (males 75%; mean age = 67.18 ± 11.35 years) and 72 spouses (mean age = 65.19 ± 11.49 years) met enrollment and analysis criteria. Most spouses were female (75%). Proxies rated patients significantly higher on the CDS (mean = 93.14 ± 29.33) than did patients of themselves (mean = 87.93 ± 26.79), t(71) = –2.05, P < 0.05. Patient–spousal concordance was low to moderate on the total CDS (concordance correlation coefficient [CCC] = 0.69) and CDS symptoms including mood (CCC = 0.35), anhedonia (CCC = 0.63), anxiety (CCC = 0.71), irritability (CCC = 0.55), hopelessness (CCC = 0.50), cognitive dysfunction (CCC = 0.41), and sleep disturbance (CCC = 0.64). Conclusions: These results suggest that spouses have limited insight into patient's psychological status, as self-reported by patients. Proxy assessments should be interpreted with caution and, wherever possible, patients should be encouraged to complete depression assessments on their own.
Transgenic animal models for study of the pathogenesis of Huntington’s disease and therapy

Huntington’s disease (HD) is caused by a genetic mutation that results in polyglutamine expansion in the N-terminal regions of huntingtin. As a result, this polyQ expansion leads to the misfolding and aggregation of mutant huntingtin as well as age-dependent neurodegeneration. The genetic mutation in HD allows for generating a variety of animal models that express different forms of mutant huntingtin and show differential pathology. Studies of these animal models have provided an important insight into the pathogenesis of HD. Mouse models of HD include transgenic mice, which express N-terminal or full-length mutant huntingtin ubiquitously or selectively in different cell types, and knock-in mice that express full-length mutant Htt at the endogenous level. Large animals, such as pig, sheep, and monkeys, have also been used to generate animal HD models. This review focuses on the different features of commonly used transgenic HD mouse models as well as transgenic large animal models of HD, and also discusses how to use them to identify potential therapeutics. Since HD shares many pathological features with other neurodegenerative diseases, identification of therapies for HD would also help to develop effective treatment for different neurodegenerative diseases that are also caused by protein misfolding and occur in an age-dependent manner.
Characterization of in vitro and in vivo huntingtin proteolysis in Huntington's disease

of Dissertation Presented to the Graduate School of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy CHARACTERIZATION OF IN VITRO AND IN VIVO HUNTINGTIN PROTEOLYSIS IN HUNTINGTON’S DISEASE By Andrew Thomas Nathaniel Tebbenkamp August 2010 Chair: David R. Borchelt Major: Medical Sciences-Genetics Huntington’s disease (HD) is caused by a CAG repeat expansion in the first exon of the huntingtin (htt) gene. When this gene is translated, the CAG encoded polyglutamine (polyQ) domain imparts an unknown toxic property on cells and results in neurodegeneration most profoundly observed in the cortex and striatum. Subcellular pathology includes neuronal inclusions reactive only to antibodies with epitopes in the N-terminus of htt, containing the polyQ domain. This immunoreactivity suggests that proteolysis of mutant htt plays a role in disease pathogenesis. This theory is supported by transgenic mice expressing mutant htt; those expressing truncated mutant htt have more robust pathology and shorter lifespans compared to mice expressing the fulllength mutant htt. Additionally, biochemical studies show that shorter htt fragments aggregate more rapidly and are more toxic to cells. To date, as many as fourteen cleavage products have been identified using cell and mouse models of HD. Calpains and caspases have been found to cleave the Nterminus of htt at multiple sites between residues 450 and 600. With one exception, these cleavage products have been verified in cells and mice, but not in human pathology. Other studies looking specifically at human pathology find inclusions
Biometry

The Textbook of Contraceptive Practice is a current overview of population control. The authors are John Peel, Senior Lecturer in Sociology, University of Hull and Malcolm Potts, Director of Medical Studies, Sidney Sussex College, Cambridge. Individual chapters cover the various methods: the oral contraceptives, intrauterine devices, withdrawal, diaphragm, spermicides, safe period, sterilization and abortion. Each method is described in detail with respect to its mode of action, suggestions for its optimal use by the patient, its effectiveness and side effects. Additional chapters consider the population explosion, the history of contraception, and medical, ethical, and legal aspects. This scope and the inclusion of recently recognized side effects of the oral contraceptives make this book unique. The oral contraceptives seem to be responsible for an increased incidence of thromboembolic phenomena, abnormal glucose tolerance curves and increased serum lipids. (Hypertension should be added to this list.) The book is clearly and well written. The small size and large print of the book (also available as a paperback) prevent in-depth documentation; selected references are provided. The authors summarize complex problems accurately and, in general, their opinions are reasonable. With the information presently available, the authors conclude that the woman who takes oral contraceptives has a greater likelihood of being alive one year later than the woman who chooses to have a baby or use some less effective method of contraception. This book should be of interest and value to everyone concerned with women. In the opinion of Dr. Alan Guttmacher, author of an earlier standard text in this field and president of Planned-Parenthood World Population, "Textbook of Contraceptive Practice is a splendid book. It is the sanest and clearest presentation of the topic I have ever read. " ARNOLD EISENFELD
Qualitative Data Analysis for Health Care Services

This study was designed enable application of multivariate technique in the interpretation of categorical data for measuring health care services satisfaction in Turkey. The data was collected from a total of 17726 respondents. The establishment of the sample group and collection of the data were carried out by a joint team from The Ministry of Health and Turkish Statistical Institute (Turk Stat) of Turkey. The multiple correspondence analysis (MCA) was used on the data of 2882 respondents who answered the questionnaire in full. The multiple correspondence analysis indicated that, in the evaluation of health services females, public employees, younger and more highly educated individuals were more concerned and complainant than males, private sector employees, older and less educated individuals. Overall 53 % of the respondents were pleased with the improvements in health care services in the past three years. This study demonstrates the public consciousness in health services and health care satisfaction in Turkey. It was found that most the respondents were pleased with the improvements in health care services over the past three years. Awareness of health service quality increases with education levels. Older individuals and males would appear to have lower expectancies in health services. Keywords—Multiple correspondence analysis, optimal scaling, multivariate categorical data, health care services, health satisfaction survey, statistical visualizing, Turkey.
Computed Tomography–Derived Thoracic Muscle Size as an Indicator of Sarcopenia in People With Advanced Lung Disease

Purpose: Computed tomography (CT) of the chest is routinely performed in people with lung disease; however, the utility of measuring thoracic muscle size to assess the presence of sarcopenia (low muscle mass and function) has not been studied. The purpose of this study was to examine the reliability and validity of thoracic muscle size obtained from chest CT as a surrogate of sarcopenia. Methods: In this observational study, chest CT was obtained from routine clinical evaluation in 32 individuals with advanced lung disease awaiting lung transplantation. Thoracic muscle area from vertebral levels T4–T6 was manually segmented using Slice-O-Matic software, and average muscle cross-sectional area (CSA) and muscle volume were calculated. Measures of sarcopenia included quadriceps CSA and thickness from ultrasound, quadriceps, and biceps torque and short physical performance battery (SPPB). Results: Intrareliability and interrater reliability for muscle CSA were high (intraclass correlation coefficient = 0.96, 0.99; absolute difference = 0.61, 1.7 cm2, respectively). Thoracic muscle CSAs and volume correlated with quadriceps size and limb muscle strength (r = 0.56–0.71, P < .001) but not SPPB. Cross-sectional areas from single slices at T4–T6 were highly correlated with muscle volume (r = 0.89–0.91, P < .001). Conclusions: Thoracic muscle size seems to be a reliable and valid technique that can be applied in large studies evaluating the presence of sarcopenia in patients with advanced lung disease.
Accuracy of Doppler Ultrasonography in Assessment of Lower Extremity Peripheral Arterial Diseases

Doppler ultrasound scan is a non-invasive, cheap and convenient tool and it complements angiography, Computed tomography angiography (CTA), magnetic resonance angiography (MRA) and catheter digital subtraction angiography (DSA) in screening, diagnosis, treatment and follow-up of peripheral vascular diseases. Symptoms of peripheral vascular diseases are becoming more common due to rise in incidence of diseases and risk factors (diabetes mellitus, dyslipidemias, smoking, sedentary lifestyle). Due to limited availability of highly specific tools such as CT angiography, magnetic resonance angiography (MRA) and DSA (digital subtraction angiography) in many developing countries, doppler ultrasound is gaining more importance. Early determination of peripheral arterial diseases is beneficial in prevention of complications as severity increases may cause intermittent claudication, pain, tissue loss, including ulceration and gangrene (as the diseases progresses) and early management of arteriosclerosis will be beneficial to prevent these complications.
A Metagenomics-Based Metabolic Model of Nitrate-Dependent Anaerobic Oxidation of Methane by Methanoperedens-Like Archaea

Methane oxidation is an important process to mitigate the emission of the greenhouse gas methane and further exacerbating of climate forcing. Both aerobic and anaerobic microorganisms have been reported to catalyze methane oxidation with only a few possible electron acceptors. Recently, new microorganisms were identified that could couple the oxidation of methane to nitrate or nitrite reduction. Here we investigated such an enrichment culture at the (meta) genomic level to establish a metabolic model of nitrate-driven anaerobic oxidation of methane (nitrate-AOM). Nitrate-AOM is catalyzed by an archaeon closely related to (reverse) methanogens that belongs to the ANME-2d clade, tentatively named Methanoperedens nitroreducens. Methane may be activated by methyl-CoM reductase and subsequently undergo full oxidation to carbon dioxide via reverse methanogenesis. All enzymes of this pathway were present and expressed in the investigated culture. The genome of the archaeal enrichment culture encoded a variety of enzymes involved in an electron transport chain similar to those found in Methanosarcina species with additional features not previously found in methane-converting archaea. Nitrate reduction to nitrite seems to be located in the pseudoperiplasm and may be catalyzed by an unusual Nar-like protein complex. A small part of the resulting nitrite is reduced to ammonium which may be catalyzed by a Nrf-type nitrite reductase. One of the key questions is how electrons from cytoplasmically located reverse methanogenesis reach the nitrate reductase in the pseudoperiplasm. Electron transport in M. nitroreducens probably involves cofactor F420 in the cytoplasm, quinones in the cytoplasmic membrane and cytochrome c in the pseudoperiplasm. The membrane-bound electron transport chain includes F420H2 dehydrogenase and an unusual Rieske/cytochrome b complex. Based on genome and transcriptome studies a tentative model of how central energy metabolism of nitrate-AOM could work is presented and discussed.
IT-structures and Algorithms for Quality Assurance in the Health Insurance Medical Advisory Service Institutions in Germany

: The 15 Regional Medical Advisory Service Institutions of the Statutory Health Insurance in Germany ( MDK ) create medical expertises ( sozialmedizinische Gutachten ) on behalf of the Statutory Health Insurance Funds in the ﬁelds of inpatient and outpatient treatment, incapacity of work and other ﬁelds. The process of internal quality assurance within the local advisory service institutions as well as between them plays an increasing role and got new impulses by actual national legislation. The assessment process was established in 2004 and covers only one single indication: long-term care. It consists in a paper-based procedure focusing on a manual distribution process performed by staff of the central quality assurance bureau. We will present organizational concepts of the new standardized regional and nationwide peer review process that will cover the multitude of all existing indications of health care. It is completely digitalized using mathematical IT-based procedures not only for randomized sampling, but as well to achieve an equal distribution of the medical expertises to be assessed by the peer Medical Advisory Service Institutions. These peer reviews are supposed to be distributed among the institutions depending on occasion groups and further subtypes of medical expertises, posing a constraint satisfaction problem that needs to be solved. Therefore we discuss models that address this kind of problem type and present possible solutions for the concrete distribution problem mentioned above. We further present our technical framework that will support the workﬂow needed for peer review distribution, data collection and ﬁnal result analysis. The 15 regional medical service institutions with different IT-system have to be connected, while data protection concerns have to be taken into account. Finally, the statistical distribution of the review results is analyzed.
Acceptance of telerehabilitation in chronic pain : the patients' perspective

Chronic pain is considered a major public health problem. In addition to the physical and emotional burden that chronic pain brings, it gives rise to significant health care costs. Although conventional rehabilitation programs are effective, the use of telerehabilitation, providing remote care via communication technologies, is expected to offer several advantages over conventional clinic-based rehabilitation because it affords patients to rehabilitate within their own social environment. This can facilitate the care delivery process, increase access of care and improve patients' well-being and quality of life. However, despite the great potential of telerehabilitation, its intended benefits will only be realized when these treatments are accepted and used by patients as fully fledged alternatives to conventional care. Therefore, an understanding of patients' reasons for accepting or refusing relerehabilitation is crucial. The aim of this thesis is to identify drivers and barriers related to patients' acceptance of exercise-based telerehabilitation for chronic pain. This will provide more insight into strategies that may improve telerehabilitation design and as such may facilitate the uptake of prospective telerehabilitation services.
Influence of taxonomic resolution on mutualistic network properties

Abstract Ecologists are increasingly interested in plant–pollinator networks that synthesize in a single object the species and the interactions linking them within their ecological context. Numerous indices have been developed to describe the structural properties and resilience of these networks, but currently, these indices are calculated for a network resolved to the species level, thus preventing the full exploitation of numerous datasets with a lower taxonomic resolution. Here, we used datasets from the literature to study whether taxonomic resolution has an impact on the properties of plant–pollinator networks. For a set of 41 plant–pollinator networks from the literature, we calculated nine network index values at three different taxonomic resolutions: species, genus, and family. We used nine common indices assessing the structural properties or resilience of networks: nestedness (estimated using the nestedness index based on overlap and decreasing fill [NODF], weighted NODF, discrepancy [BR], and spectral radius [SR]), connectance, modularity, robustness to species loss, motifs frequencies, and normalized degree. We observed that modifying the taxonomic resolution of these networks significantly changes the absolute values of the indices that describe their properties, except for the spectral radius and robustness. After the standardization of indices measuring nestedness with the Z‐score, three indices—NODF, BR, and SR for binary matrices—are not significantly different at different taxonomic resolutions. Finally, the relative values of all indices are strongly conserved at different taxonomic resolutions. We conclude that it is possible to meaningfully estimate the properties of plant–pollinator interaction networks with a taxonomic resolution lower than the species level. We would advise using either the SR or robustness on untransformed data, or the NODF, discrepancy, or SR (for weighted networks only) on Z‐scores. Additionally, connectance and modularity can be compared between low taxonomic resolution networks using the rank instead of the absolute values.
Newly graduated nurses working in isolation with palliative patients

Aim: This paper highlights the experiences of new graduate nurses working in rural areas, as they face the task of working with palliative care patients in rural health settings with limited assistance and mentoring. Background: There are a number of complicating factors that will influence how and where a person with a life limiting illness is cared for during the palliative stage of their condition. Nurses need to be mindful of these factors and their ability to offer quality care, which is dependent on the extent of their preparation for this area of practice. Although literature exists about how to provide end of life education to undergraduate nurses, there is little published about the experiences of new graduate nurses working in remote or isolated geographical regions. Method: Participants who had graduated 1-2 years previously received invitations to be interviewed through the University Alumni. Interviews were analysed thematically. Results: This paper describes the experiences of new graduate nurses working in isolation with palliative patients. Conclusions: Palliative care is viewed as an important feature of undergraduate nursing education, but is often identified as an area of practice where undergraduate nurses feel inadequately prepared. This paper describes the experiences of new graduate nurses in rural areas in their role of caring for patients with life limiting illness.
Artificial intelligence system can achieve comparable results to experts for bone age assessment of Chinese children with abnormal growth and development

Objective Bone age (BA) is a crucial indicator for revealing the growth and development of children. This study tested the performance of a fully automated artificial intelligence (AI) system for BA assessment of Chinese children with abnormal growth and development. Materials and Methods A fully automated AI system based on the Greulich and Pyle (GP) method was developed for Chinese children by using 8,000 BA radiographs from five medical centers nationwide in China. Then, a total of 745 cases (360 boys and 385 girls) with abnormal growth and development from another tertiary medical center of north China were consecutively collected between January and October 2018 to test the system. The reference standard was defined as the result interpreted by two experienced reviewers (a radiologist with 10 years and an endocrinologist with 15 years of experience in BA reading) through consensus using the GP atlas. BA accuracy within 1 year, root mean square error (RMSE), mean absolute difference (MAD), and 95% limits of agreement according to the Bland-Altman plot were statistically calculated. Results For Chinese pediatric patients with abnormal growth and development, the accuracy of this new automated AI system within 1 year was 84.60% as compared to the reference standard, with the highest percentage of 89.45% in the 12- to 18-year group. The RMSE, MAD, and 95% limits of agreement of the AI system were 0.76 years, 0.58 years, and −1.547 to 1.428, respectively, according to the Bland-Altman plot. The largest difference between the AI and experts’ BA result was noted for patients of short stature with bone deformities, severe osteomalacia, or different rates of maturation of the carpals and phalanges. Conclusions The developed automated AI system could achieve comparable BA results to experienced reviewers for Chinese children with abnormal growth and development.
The case for exercise is medicine as an intervention in endometrial cancer survivors

The 2018 American Cancer Society estimates that about 63,230 women will be diagnosed with endometrial, womb or uterine, cancer and 11,350 women will die from endometrial cancer (EC) (1). Worldwide, 320,000 new cases were recorded in 2012, whereby making EC the sixth most common cancer in women, and the 14th most common cancer overall (2).
New Approaches to Collecting Family Health History – A Preliminary Study Investigating the Efficacy of Conversational Systems to Collect Family Health History

Knowing and compiling your family health information is an important, cost-effective and efficient way to help your doctor screen and monitor for risks of genomic diseases such as cancer. There are several ways to collect family health history, including the use of digital records. Digital records can be helpful for sharing and updating information among family members. However, minimal research has been conducted to compare the different data collection interfaces. This study focuses on evaluating the user’s performance and preference between a conversational interface that we developed and a traditional interface for compiling family health history. Using a within-subjects design, twenty participants were asked to perform several tasks using both platforms. Although the conversational interface required more clicks, participants reported lower workload, higher performance and greater ease-of-use with this platform, and preferred the guidance of the virtual assistant.