Miracle-dz/UniFAR-FTUs huggingface dataset:
Determinants of Patterns of Need for Home and Community-Based Care Services Among Community-Dwelling Older People in Urban China: The Role of Living Arrangement and Filial Piety

This study aims to identify older people’s home- and community-based care (HCBC) service need patterns and explore the role of living arrangement and filial piety in affecting such patterns. A total of 556 older people were selected in Beijing, China. Latent class analysis and multinomial logistic regression were adopted to identify the service need patterns and the influencing factors. A three-class model of service need patterns was explored (high-needs group, moderate-needs group, and low-needs group). Living arrangement was related to HCBC service need patterns. Compared with the high-needs group, those living with at least two family members were more likely to express low needs or moderate needs. Living arrangement was a moderator for the effect of filial piety on HCBC needs. Greater recognition of the effects of living arrangement and filial piety should enrich the Andersen model and provide a robust stimulus for long-term care policy development and for service delivery and social work.
Surgical Management of IIIA/N2 Non-Small Cell Lung Cancer: A Systematic Review

Background: Non-Small Cell Lung Cancer (NSCLC) stage IIIA/N2 (cT1-3N2M0) represents a heterogenic group, and depending on the level of lymph node involvement, prognosis varies within this group. Optimal treatment is debated, and patients may have benefit from combined treatment modalities. The aim of this study was to assess the evidence regarding surgical treatment of stage IIIA/N2 NSCLC diagnosed before commencement of treatment. Methods: A systematic literature search for Randomized, Controlled Trials (RCT) comparing various combinations of treatments with surgery. Extraction of relevant data was performed, including study characteristics, patient characteristics, quality of trials and survival outcomes. Results: Five RCT’s with a total of 1166 patients were included. Treatment modalities varied substantially. None of the included studies found a statistically significant improved median overall survival, and only one study found an improved progression free survival when patients received chemotherapy, radiotherapy and surgery. Results, however indicates better locoregional control with surgery. Conclusion: Current clinical guidelines are not based on high-quality evidence. To assess the existing high-quality evidence on this subject, only RCT’s were included in this review. Results of statistical significance on survival are lacking, and studies show poor methodical quality. Based on the evidence available, surgery is not superior compared to other treatment modalities. Further subgroup analyses are needed, as evidence points toward surgery being beneficial for a subgroup of patients, possibly those with single-station N2 disease. RCT’s of high methodical quality are needed to determine optimal chemotherapy regimens, radiotherapy and concomitant surgical intervention.
Effects of Rest Position on Morphology of the Vastus Lateralis and Its Relationship with Lower-Body Strength and Power

Ultrasonography of the lower body typically encompasses supine rest due to fluid shifts affecting tissue size and composition. However, vastus lateralis (VL) examination is completed in the lateral recumbent position, and this positional change may influence morphology and its ability to predict function. This study aimed to examine the effect of position on VL morphology and its relationship with lower-body performance. Cross-sectional area (CSA), muscle thickness (MT), pennation angle (PA), echo intensity (UnCorEI), subcutaneous adipose tissue thickness (SFT), and echo intensity corrected for SFT (CorEI) were assessed in 31 resistance-trained males (23.0 ± 2.1 yrs; 1.79 ± 0.08 m; 87.4 ± 11.7 kg) immediately after transitioning from standing to supine (IP), after 15 min of standing (ST), and after 15 min of rest in three recumbent positions: supine (SUP), dominant lateral recumbent (DLR), non-dominant lateral recumbent (NDLR). Participants also completed unilateral vertical jumps, isometric/isokinetic tests, and a one-repetition maximum leg press. CSA, MT, PA, and SFT were greater in ST compared to NDLR, DLR, and SUP (p < 0.05). CSA, UnCorEI, and CorEI were different between recumbent positions; however no differences were observed for MT, PA, and SFT. Different magnitudes of relationships were observed between muscle morphological characteristics measured after rest in different positions and performance variables. Muscle morphology in IP generally appears to be the best predictor of performance for most variables, although utilizing the NDLR and DLR positions may provide comparable results, whereas morphology measured in ST and SUP provide weaker relationships with physical performance. IP also requires less time and fewer requirements on the technician and subject, thus researchers should consider this positioning for VL examination.
Unexpected challenges to preventing falls in older adults: a mixed methods study of an emergency department-based falls prevention referral pilot project

Objective: We sought to determine the rate and challenges to follow-up with a fall prevention program after an Emergency Department (ED) based referral. Methods: We conducted a mixed-methods study of a pilot ED falls referral program. Older ( ≥ 65) patients who presented to the ED with fall-related injury were enrolled. We held semi-structured interviews in the ED and referred fall patients to an outpatient fall prevention program. We assessed quantitative outcomes, including 6-month mortality and recurrence of falls, and conducted follow-up phone interviews. Results: One hundred geriatric patients patients were enrolled and 22 were referred. None (0%) participated in the program. After 6 months, the mortality rate was 8.5% and 28% of the patients had recurrent falls. Qualitative data revealed that challenges to fall prevention were 1) practical considerations, 2) competing health issues, and 3) perceptions of fall risk. Conclusion: None of our patients followed up in an outpatient falls program. Our patients had a high rate of recurrent falls. Follow-up interviews revealed that ED referral alone is not enough to overcome challenges to participation in a fall prevention clinic. Actively addressing barriers to fall clinic follow-up is necessary to improve outpatient fall clinic show rates.
Effect of elastic abdominal binder on pain and functional recovery after caesarean delivery: a randomised controlled trial

Abstract The Elastic abdominal binder has been widely employed by clinicians for pain relief, wound complications prevention, improved pulmonary function, and stabilisation. However, these proposed benefits have not been properly examined in women following caesarean delivery. We aimed to examine the effects of post-caesarean elastic abdominal binder use on recovery by comparing post-operative pain, mobility and quality of life. Pregnant women undergoing caesarean delivery were randomly assigned into two groups: abdominal binder (90 patients) and control (90 patients). The primary outcomes included the daily visual analogue scale pain scores and the distance from the six-minute walk test. Baseline characteristics were similar between the groups. There was no significant difference in pain scores and six-minute walking distance between the study groups. There was no significant between-group difference in quality-of-life dimensions, overall health status, and post-operative complication. The positive effects of elastic abdominal binder use following caesarean delivery could not be demonstrated in this study. Impact statement What is already known on this subject? Elastic abdominal binder is commonly used after laparotomy to support incision. There was evidence to support the benefit of abdominal binder in reducing psychological distress during the first five days following laparotomy for other indications. From limited number of studies addressing caesarean section, the evidence for the benefits of the binder on pain, symptom distress, and change in haemoglobin level is conflicting. What do the results of this study add? In contrast to the results of the previous study, the beneficial effects of abdominal binder on pain reduction, functional recovery, and quality of life following caesarean delivery could not be demonstrated in this study. What are the implications of these findings for clinical practice and/or further research? The use of elastic abdominal binder after caesarean delivery is not associated with reduction of postoperative pain, faster functional recovery, and improved quality of life in our population. Further studies in other population with different characteristics may be worthwhile.
Screening for mental disorders in post-conflict regions using computer apps - a feasibility study from Burundi

A high level of psychosocial functioning is essential for survival in many resource-poor countries and is needed for development in these regions. Organized violence, often in combination with other stressors such as poverty and familial conflict, however, result in a range of mental disorders and damage socio-economic progress. An efficient assessment of mental health is a prerequisite for prevention and intervention measures. However, this may require considerable resources that are difficult to obtain in resource-poor countries. We present new methods for the efficient and effective assessment of mental, especially trauma- and stress-related disorders that can easily be administered by trained local paramedics. For decades, Burundi has been a staging ground for armed conflicts leaving behind many survivors with trauma-related illness. In a study with over 900 combatants and veterans from the military as well as former rebels in Burundi, we used a tablet-computer (ipad)-based survey for the assessment of trauma-related syndromes, especially PTSD, in need for treatment. All participants reported the experience of serious traumatic stressors and a substantial portion presented severe symptoms of the trauma-spectrum. Based on the PSS-I and other standardized screening instruments, an ipad app guided the semistructured clinical interviews. Psychologists from the University of Konstanz, the Burundian military as well as psychologist students from the University Lumie` re, Bujumbura, Burundi carried out the interviews. In this contribution, we use the Burundian example to portray the logistics and technology of data acquisition and present respective data. We demonstrate the feasibility of using a computerbased screening approach in the field and in clinical settings. We provide evidence, that the computerized assessment of clinical symptoms can be a useful tool for mental health assessment and screenings, both in research and practice.
Further report of a prospective randomized trial comparing distal splenorenal shunt with end-to-side portacaval shunt

Abstract We electively compared the distal splenorenal ("selective") shunt with the end-to-side portacaval shunt in 80 prospectively randomized patients with variceal bleeding. Selective shunts required more operative time (3.9 vs. 2.8 h) and blood replacement (4.6 vs. 2.5 U) and postoperative mortality was slightly higher (5 of 38 selective vs. 0 of 40 portacaval). Postoperative complication rates were similar. After 65-mo mean follow-up, both shunts have protected well against late gastrointestinal bleeding (5 selective, 4 portacaval episodes). However, after selective shunts, spontaneous encephalopathy occurred less often (23% vs. 40% of patients), was severe in fewer patients (12% vs. 33%), and precipitated fewer hospital admissions (6 admissions in 4 selective patients vs. 26 admissions in 13 portacaval patients). Furthermore, selective shunt patients remained longer without functional disability (83% vs. 70% of postoperative patient months). Long-term survival was not significantly different in the two groups (5-yr survival: selective 51%, portacaval 56%).
Investigating the role of the insulin-like growth factor receptor (IGF1R) on axonal transport as a target for pharmacological intervention in Amyotrophic Lateral Sclerosis

3 Acknowledgements . 4 Impact statement . 5 Table of contents . 6 List of figures . 10 List of tables . 12 Abbreviations . 13 Chapter 1: Introduction . 15 1.1 Axonal transport . 15 1.1.1 Fast vs slow axonal transport . 15 1.1.2 Neuronal morphology and cytoskeleton . 16 1.1.3 Molecular motor proteins . 18 1.2 Axonal transport and disease . 23 1.2.1 Mutations in the transport machinery . 23 1.2. 2 Axonal transport and neurodegeneration . 24 1.3 Amyotrophic lateral sclerosis . 28 1.3. 1 Genetics of ALS . 29 1.3. 2 Pathomechanisms involved in the development of ALS . 29 1.3. 3 ALS and deficits in axonal transport . 30 1.4 Targeting kinases as a therapeutic in ALS . 32 1.4. 1 IGF1R structure and signalling . 32 1.4. 2 IGF1R function in the nervous system . 34 1.4. 3 Targeting IGF1R in ALS . 34 1.5 Aims . 36 Chapter 2: Materials and methods . 37 2.1 Reagents and media . 37
Drug-induced liver injury

Drug-induced liver injury (DILI), including herbal and dietary supplement hepatotoxicity, is often passed lightly; however, it can lead to the requirement of a liver transplant or may even cause death because of liver failure. Recently, the American College of Gastroenterology, Chinese Society of Hepatology and European Association for the Study of the Liver guidelines for the diagnosis and treatment of DILI have been established, and they will be helpful for guiding clinical treatment decisions. Roussel Uclaf Causality Assessment Method scoring is the most commonly used method to diagnose DILI; however, it has some limitations, such as poor validity and reproducibility. Recently, studies on new biomarkers have been actively carried out, which will help diagnose DILI and predict the prognosis of DILI. It is expected that the development of new therapies such as autophagy inducers and various other technologies of the fourth industrial revolution will be applicable to DILI research.
Dyslipidemia and oxidative stress are causative factors for atherosclerosis changes in hemodialysis patients

Background: Cardiovascular disease is one of the leading cause of death in chronic kidney disease. The increased cardiovascular mortality observed in all stages of Chronic kidney disease patients. In hemodialysis cardiovascular mortality is more than 60%. In hemodialysis dyslipidemia contribute for the triggering of atherosclerosis. Endothelial dysfunction and oxidative stress are serves as main precursor for the progression of atherosclerosis. So the present study was aimed at studying lipid profile and oxidative stress in hemodialysis patients.Methods: A cross sectional study carried out over a 2 year period in Department Nephrology and General Medicine OPD, MIMS, Vizianagaram, Andhra Pradesh, India. A total of 60 hemodialysis patients are included. In all the participants Lipid profile, SOD, MDA and Serum Nitrate was measured. Results: There is a significantly increased levels of serum triglycerides and VLDL in hemodialysis patients when compared with Control. The HDL-C was significant Lower in hemodialysis patients when compared with control. The serum total cholesterol and LDL-C not shown any significant change. The Serum MDA and Serum Nitrate was significantly higher in hemodialysis patients compared with Control and it is statistically significant (p<0.001). Whereas the serum SOD value was significantly decreased in hemodialysis patients when compared with control and it is statistically significant (p<0.001). Conclusion: Present study finding suggested that the incidence of atherosclerosis changes are higher in hemodialysis patients. Early detection and correction of atherosclerosis changes can help us to reducing the deleterious effects.
Determination of vascular responses to manual PC6 acupuncture in subjects healthy and diabetics by the second derivative of the finger photoplethysmogram waveform

Type 2 diabetes mellitus is a significant risk factor in the development and progression of arterial stiffness (Elias et al., 2018); and a is a key determinant of left ventricular remodeling, arterial st iffness, adverse pulsatile hemodynamics, and ventricular-arterial interactions in subjects with heart failure (Chirinos et al., 2019). Moreover, in subjects with impaired fasting glucose arterial stiffness was higher than in subjects with normal fasting glucose (Paik et al., 2012).
Medical Choices, Medical Chances: How Patients, Families, and Physicians Can Cope with Uncertainty

Much of the frustration and disappointment in medical practice, even the extreme cases where an adversarial relationship arises, grow out of a failure on the part of the patient and/or the doctor to acknowledge uncertainty. "Medical Choices, Medical Chances" is the result of an unusual collaborative effort by a group of health professionals. It grew out of the wake of the holistic health movement, the consumer movement in medicine, and the patient rights movement. Many of these issues seemed to centre on the notion of uncertainty. In "Medical Choices, Medical Chances", medical decision-making is seen as a shared responsibility between doctor and patient, aimed at helping the patient get well and stay well. The authors show how most medical practice is based on what they call the mechanistic paradigm, the model being hard science and the aim to find-the-cause-and-cure-it. They demonstrate how contemporary scientific thought encourages the mutual acknowledgement of uncertainty and recognizes values and feelings to be an inescapable concern of science. The insight this book provides into how decisions are made and better ways of making them will help the reader, not only in medical matters, but in many other areas of human concern.
Understanding the Bacterial Response to Mycotoxins: The Transcriptomic Analysis of Deoxynivalenol-Induced Changes in Devosia mutans 17-2-E-8

Deoxynivalenol (DON) is a major fusarium toxin widely detected in cereal grains. The inadvertent exposure to this fungal secondary-metabolite gives rise to a myriad of adverse health effects including appetite loss, emesis, and suppression of the immune system. While most of the attention this mycotoxin has gained in the past four decades was related to its eukaryotic toxicity (monogastric animals and plants more precisely), recent studies have begun to reveal its negative influence on prokaryotes. Recently presented evidence indicates that DON can negatively affect many bacterial species, raising the possibility of DON-induced imbalances within the microbiota of the human and animal gut, in addition to other environmental niches. This in turn has led to a greater interest in understanding bacterial responses toward DON, and the involved mechanism(s) and metabolic pathways, in order to build a more comprehensive picture of DON-induced changes in both prokaryotes and eukaryotes alike. This study reveals the transcriptomic profiling of Devosia mutans strain 17-2-E-8 after the inclusion of DON within its growth medium. The results highlight three adaptive mechanisms involved in the response of D. mutans 17-2-E-8 to this mycotoxin, which include: (a) activation of adenosine 5’-triphosphate-binding cassette transporters; (b) engagement of a toxin-specific pyrroloquinoline quinone-dependent detoxification pathway; and finally (c) the upregulation of auxiliary coping proteins such as porins, glutathione S-transferases, and phosphotransferases. Some of the identified mechanisms are universal in nature and are shared with other bacterial genera and species.
Fully bioresorbable scaffolds for coronary artery disease

Coronary artery disease (CAD), a manifestation of atherosclerosis of the coronary arteries, belongs to the most prevalent diseases and is the leading cause of death in Austria. Different revascularisation techniques have been developed to restore blood flow. The most recent developments in stent technology are fully bioresorbable vascular scaffolds (BVS), designed to slowly disintegrate over time. To date, two products (ABSORB®, DESolve®) have received a CE-mark. The current evidence is not sufficient to prove that the BVS is more, or at least equally effective and safer than current revascularisation technologies. Therefore, the inclusion in the Austrian catalogue of benefits is currently not recommended. We suggest a re-evaluation in 2018.
Antígeno plaquetários humanos (HPA) em portadores do vívus da hepatite c (HCV)

Hepatic fibrosis leading cirrhosis in 20 to 30% of patients with chronic hepatitis C virus (HCV) infection. Rapid progression to fibrosis has been related to environmental, viral and host factors. However, genetic polymorphisms have recently been associated with this progression, including the expression of integrins. Platelet membrane glycoproteins express several polymorphic antigenic determinants on their surface, which are called human platelet antigens (HPA). HPA-1, -3, -4 and -5 reside in integrins. The association between HPA antigens and stage of fibrosis can determine if HPA is related to progression of fibrosis. Thus, the goal of this study was to determine the association between the HPA-1, -3, -4 and -5 and the liver fibrosis stage in 175 HCV-infected patients. HPA-1, -3 and -4 genotyping was performed by PCR-SSP and, HPA-5 by PCR-RFLP. Fibrosis progression was evaluated using the METAVIR scoring system. There were no significant differences (p>0.05) in allelic and genotypic frequency distribution of HPA-1, -3 and -5, residing in integrins.
Treat and Extend Treatment Interval Patterns with Anti-VEGF Therapy in nAMD Patients

Treat and extend (T&E) is a standard treatment regimen for treating neovascular age-related macular degeneration (nAMD) with anti-vascular endothelial growth factors (anti-VEGFs), but the treatment intervals attained are not well documented. This retrospective, non-comparative, non-randomised study of eyes with nAMD classified treatment interval sequences in a T&E cohort in Australia using Electronic Medical Records (EMR) data. We analysed data from 632 treatment-naïve eyes from 555 patients injected with ranibizumab, aflibercept or unlicensed bevacizumab between January 2012 and June 2016 (mean baseline age 78.0). Eyes were categorised into non-overlapping clusters of interval sequences based on the first 12 months of follow-up. We identified 523 different treatment interval sequences. The largest cluster of 197 (31.5%) eyes attained an 8-week treatment interval before dropping to a shorter frequency, followed by 168 (26.8%) eyes that did not reach or attained a single 8-week interval at the end of the study period. A total of 65 (10.4%) and 83 (13.3%) eyes reached and sustained (≥2 consecutive injection intervals of the same length) an 8 and 12 weekly interval, respectively. This study demonstrates highly individualised treatment patterns in the first year of anti-VEGF therapy in Australia using T&E regimens, with the majority of patients requiring more frequent injections than once every 8 weeks.