Miracle-dz/UniFAR-FTUs huggingface dataset:
Using implementation science to build intimate partner violence screening and referral capacity in a fracture clinic.

RATIONALE, AIMS, AND OBJECTIVES Over the past two decades, research informing good clinical practices related to intimate partner violence (IPV) has been plentiful, yet partner violence screening remains challenging to translate into action. In spite of the documented efficacy of routine screening for women of reproductive age and the availability of validated screening instruments, many IPV screening programmes lack the components necessary for success. In Toronto, a multidisciplinary team of researchers and clinicians is using the tools of implementation science to scale up an evidence-based IPV screening and response programme in an urban orthopaedic clinic where prior screening attempts have been ineffective. METHODS Using the Active Implementation Framework as a guide, researchers collected data across multiple sources to inform the first stage of implementation. Analysis focused on identifying the characteristics of the clinic that support or hinder implementation of new processes, evidence-based screening practices that fit with the clinic, and characteristics of a strong implementation team. RESULTS Through this process, researchers and clinicians uncovered organizational strengths and weaknesses related to IPV screening that may not have been identified previously. The need to incorporate technology into our screening processes became apparent, as did the importance of shared communication and colearning between clinicians and researchers. CONCLUSIONS The benefits of investing in the preparatory phases of implementation are discussed. Without undertaking the process of gathering and analysing data, examining the factors that support effective and sustainable implementation, and investing in the creation of a strong implementation team, it is likely that decisions about our screening approaches would have resulted in a less-effective and sustainable process.
Primary insomnia patients’ performances during simulated car following and urban driving in the afternoon

According to epidemiological studies, insomnia is associated with an increase in risk of traffic accidents. Recent investigations revealed that patients with insomnia had driving performance impairment under monotonous conditions. However, it is unclear whether other driving abilities may be impacted by insomnia, especially those needing more attentional resources than those involved in monotonous driving. Other findings revealed that impaired performances are more likely to occur with the increase of cognitive demands. However, such tests did not reflect difficulties in situations of everyday life expressed by patients with insomnia, such as driving in an urban environment with traffic and critical situations. Therefore, behaviour in situations encountered in everyday life has to be explored. The aim of the present study was to assess driving performances of patients with insomnia in daily routine tasks such as urban and car‐following tests. For this purpose, 15 patients with insomnia and 16 good sleepers performed an urban test of driving with original risk scenarios and a car‐following test during the middle afternoon. No significant behavioural difference between patients with insomnia and good sleepers has been found in both the urban test and the car‐following test, showing that patients with insomnia have no impairment in behaviour implicated in daily contexts driving tasks of short period of time performed in the late afternoon. Although our results provide a first step towards knowledge of behavioural performance during daily routine driving tasks in patients with insomnia, future studies are needed using on‐the‐road driving tests and/or different population of patients with insomnia before generalisation.
Evaluation of Forgotten Joint Score in total hip arthroplasty with Oxford Hip Score as reference standard

Background and purpose — Total hip arthroplasty (THA) is performed mainly because of pain. To evaluate the result after surgery, different questionnaires measuring the patient-reported outcome regarding quality of life are used. Forgotten Joint Score (FJS), designed to chart postoperative symptoms, was developed to find subtle differences between patients who report that their operated hip is “very good” or “excellent. ” We evaluated whether FJS provides additional information compared with the Oxford Hip Score (OHS) and ceiling and floor effects with use of these instruments. We also studied level of internal consistency for OHS and FJS, and the reproducibility of the FJS. Patients and methods — 111 patients who underwent unilateral primary THA in 2015 were included. The participants answered 2 questionnaires: Forgotten Joint Score and Oxford Hip Score. Floor and ceiling effects were recorded for each of the instruments and agreement between them. The FJS was studied with respect to reproducibility and level of internal consistency. Results — OHS ceiling effect (31%) was higher compared with FJS (21%), whereas the OHS seemed to provide a more nuanced picture of patients with an inferior clinical result. Floor effect for FJS was 3% and 0% for OHS. The degree of explanation was 68% between the 2 questionnaires (linear regression, r2 = 0.68). FJS items had a high internal consistency (Cronbach’s a = 0.93) and reproducibility (Pearson correlation = 0.87, ICC = 0.93); 92 patients answered on 2 distributions of the FJS questionnaires, 19 patients had identical answers. Interpretation — OHS had a larger ceiling effect than FJS, which could indicate that FJS is a more fine-tuned instrument to separate patients with good to excellent outcome after THA. The high internal consistency of FJS indicates that the items of the instrument consistently cover the construct of joint awareness.
Observation of Angular Dependence of T1 in the Human White Matter at 3T.

Background and objective Multiple factors including chemical composition and microstructure influence relaxivity of tissue water in vivo. We have quantified T1 in the human white mater (WM) together with diffusion tensor imaging to study a possible relationship between water T1, diffusional fractional anisotropy (FA) and fibre-to-field angle. Methods An inversion recovery (IR) pulse sequence with 6 inversion times for T1 and a multi-band diffusion tensor sequence with 60 diffusion sensitizing gradient directions for FA and the fibre-to-field angle θ (between the principal direction of diffusion and B0) were used at 3 Tesla in 40 healthy subjects. T1 was assessed using the method previously applied to anisotropy of coherence lifetime to provide a heuristic demonstration as a surface plot of T1 as a function of FA and the angle θ. Results Our data show that in the WM voxels with FA > 0.3 T1 becomes longer (i.e. 1/T1 = R1 slower) when fibre-to-field angle is 50-60°, approximating the magic angle of 54.7°. The longer T1 around the magic angle was found in a number of WM tracts independent of anatomy. S0 signal intensity, computed from IR fits, mirrored that of T1 being greater in the WM voxels when the fibre-to-field angle was 50-60°. Conclusions The current data point to fibre-to-field-angle dependent T1 relaxation in WM as an indication of effects of microstructure on the longitudinal relaxation of water.
Bioglass in Alveolar Bone Regeneration in Orthodontic Patients

This study was designed as a split-mouth randomized controlled clinical trial to evaluate the effects of a novel bioactive glass scaffold—tailored amorphous multiporous (TAMP)—for the preservation of alveolar bone following tooth extraction in class II orthodontic patients. TAMP scaffolds were prepared and sterilized. Patients were screened for eligibility, and 6 patients accounting for 14 extraction sockets were included in this stage. Sockets were randomly allocated to either control (left empty) or test (grafted with TAMP scaffold particles). Follow-up was done after 1, 2, 4, 8, and 12 to 17 wk with digital periapical radiographs to evaluate changes in crestal bone height and bone mineral density (BMD), 3-dimensional volumetric analysis of impression casts, and histologic analysis of core biopsies. Furthermore, alveolar bone marrow mesenchymal stem cells were cultured from control and test sockets following biopsy retrieval to evaluate the ability of TAMP bioactive glass scaffolds to recruit host progenitor cells. Results showed that sockets grafted with TAMP bioactive glass scaffolds better preserved height after 3 mo where mesially 57.1% of test cases showed preservation of socket height, compared with 28.6% of control cases. Distally, this was 42.9% of test cases versus none of the control cases. Regarding BMD, the test sides had higher BMD in all 3 sections of the socket, with the greatest reduction in BMD found in the coronal third. Results were not statistically significant. Histologically, sockets grafted with TAMP bioactive glass scaffolds showed a distinct pattern of bone healing characterized by vertical trabeculae and large vascularized marrow spaces with sockets showing corticalization. Volumetric analysis showed a better preservation of socket contour with TAMP bioactive glass scaffolds. TAMP bioactive glass scaffolds appeared to enhance the recruitment of stem cells from the grafted sockets. In conclusion, TAMP scaffolds appear to better preserve alveolar bone following extraction and allow for a more active bone modeling and remodeling process(ClinicalTrials.gov identifier:NCT01878084). Knowledge Transfer statement: The results of this study set the stage for the recommended use of novel biomimetic scaffolds, such as the tailored amorphous multiporous bioactive glass for preservation of the socket following extraction. This can be valuable for patients and clinicians alike when deciding on long-term prosthetic alternatives that not only result in immediate bone preservation but will accommodate the dynamic nature of bone.
The Impact of Child Abuse on Relationships between Resource Loss and Posttraumatic Stress: A Cross-Lagged Panel Analysis

ABSTRACT Childhood abuse is a serious and prevalent public health concern, both in the United States and around the world. The association between child abuse and adverse outcomes in adulthood is well-established, with those experiencing abuse more likely to be diagnosed with mental health disorders, including posttraumatic stress disorder (PTSD), into adulthood. One way to conceptualize the relationship between trauma and adverse mental health outcomes in adulthood is through resource loss. Previous research indicates that individuals who have experienced childhood abuse may not adequately develop resources, such as tangible (e.g., money) and intangible (e.g., emotional) support systems, with the loss of these resources associated with decreased ability to cope with distress. The current study investigated the relationship between resource loss and symptoms of posttraumatic stress longitudinally in a sample of women who had experienced both childhood abuse and a mass-shooting event. Results demonstrated that experiencing childhood physical abuse and sexual abuse predicted symptoms of posttraumatic stress after controlling for exposure to the mass-shooting event. Additionally, symptoms of posttraumatic stress and resource loss predicted each other at two time points after the shooting. Findings demonstrate the bidirectional nature of the relationship between posttraumatic stress and resource loss, as well as highlight how effects of childhood abuse can be long-standing and negatively impact psychosocial functioning in women throughout adulthood.
Structural and functional connectivity correlates with motor impairment in chronic supratentorial stroke: a multimodal magnetic resonance imaging study

The aim of this study was to identify differences in structural and functional brain connectivity between poststroke mild and severe motor impairment. Twenty-four chronic stroke patients who underwent resting-state functional MRI and diffusion tensor image were retrospectively included. All patients were classified into two groups (mild motor impairment: 11 patients and severe motor impairment: 13 patients) according to their Fugl-Meyer motor assessment score. Tract-based spatial statistics and group independent component analyses were applied to investigate between-group differences in structural and functional connectivity, respectively. The fractional anisotropy values of motor-related brain regions in the affected hemisphere were significantly higher in mild motor impairment than in severe motor impairment (corrected P<0.05). The internetwork functional connectivity between (i) the supplementary motor area and primary motor cortex in the affected hemisphere, (ii) the supplementary motor area and dorsolateral prefrontal cortex in the unaffected hemisphere, and (iii) the ischemic lesion and primary motor cortex in the unaffected hemisphere was significantly higher in mild motor impairment than in severe motor impairment (PFWE<0.05). Better motor recovery after stroke could be facilitated by means of treatments aimed at enhancing structural and functional connectivity among motor-related brain regions such as noninvasive brain stimulation and neurodevelopmental therapy.
Formulation of sustained release bioadhesive minitablets containing solid dispersion of levofloxacin for once daily ocular use

Abstract This study aimed to increase ocular residence time of levofloxacin by formulation into zero-order sustained release mucoadhesive minitablets for once daily administration using a hydrophobic–hydrophilic polymeric matrix. Levofloxacin was first formulated into solid dispersion with different ratios of Eudragit® RS then the resulting solid dispersion was mixed with different concentrations of Carbopol® and other excipients to be finally compressed into minitablets. A 24 full factorial design was employed to estimate the effects and interactions of two formulation factors, and to establish their relationships with selected responses in the developed minitablets. The studied factors were: drug to Eudragit® RS ratio, and percent of Carbopol® in the minitablets. Sixteen ocular minitablets formulations were prepared and evaluated for the cumulative percentages drug release at 6, 12, and 24 h, as well as mucoadhesion time, mucoadhesive strength, and swelling index as response variables. After optimizing the responses, the optimized formulation was found to be stable on sterilization using gamma-irradiation and storage at 40 °C/75% RH for six months. In vivo testing of the optimized formulation showed that the minitablets extended levofloxacin release up to 24 h without causing any ocular irritation. The optimized formulation exhibited superior microbiological activity compared to the commercial product.
Comparative pharmacokinetics of tacrolimus in stable pediatric allograft recipients converted from immediate‐release tacrolimus to prolonged‐release tacrolimus formulation

This study was a Phase II, open‐label, multicenter, single‐arm, cross‐over study comparing the pharmacokinetics (PK) of tacrolimus in stable pediatric kidney, liver, or heart allograft recipients converted from immediate‐release tacrolimus (IR‐T) to prolonged‐release tacrolimus (PR‐T). In Days −30 to −1 of screening period, patients received their IR‐T‐based regimen; during Days 1‐7, patients received study IR‐T (same dose as screening). On Day 7, the first 24‐hours PK profile was taken; patients were then converted to PR‐T (1 mg:1 mg), with a second 24‐hours PK profile taken on Day 14. The primary end‐point was tacrolimus area under the blood concentration–time curve over 24 hours (AUC24); secondary end‐points were maximum concentration Cmaxand concentration at 24 hours C24. The predefined similarity interval for confidence intervals (CIs) of least squares mean (LSM) ratios was 80%‐125%. The PK analysis set comprised 74 pediatric transplant recipients (kidney, n = 45; liver, n = 28; heart, n = 1). PR‐T:IR‐T LSM ratio (90% CI) was similar overall for AUC24, max, and C24, and for kidney and liver recipients for AUC24 (LSM ratio, kidney 91.8%; liver 104.1%) and C24 (kidney 90.5%; liver 89.9%). Linear relationship was similar between AUC24 and C24, and between PR‐T and IR‐T (rho 0.89 and 0.84, respectively), suggesting that stable pediatric transplant recipients can be converted from IR‐T to PR‐T at the same total daily dose, using the same therapeutic drug monitoring method.
Effectiveness of alternative routes of intra-arterial chemotherapy administration for retinoblastoma: Potential for response and complications

Objective Intra-arterial chemotherapy (IAC) is now the first line treatment for selected patients with retinoblastoma (Rb). Typically, IAC is infused following the selective catheterization of the ophthalmic artery (OA) on the affected side. However, in some patients, the OA alone may not provide vascular supply to the tumor, whereas in other instances the efficacy of IAC could be compromised due to the presence of prominent collateral vessels from the external carotid artery (ECA). We report our experience with catheterizing vessels other than the OA for IAC treatment for Rb. Methods After institutional review board approval, a retrospective analysis was conducted of electronic medical records and imaging of our Rb population. Results We identified 13 patients who received IAC for Rb treatment. Of these, five patients required alternative methods of chemotherapy delivery other than through the OA, totaling 17 treatments. Two patients needed balloon-assisted occlusion of the ECA, two patients required selective catheterization of the middle meningeal artery, and one patient had no internal carotid artery supply to the choroidal blush, thus the superficial temporal artery provided access for IAC. Total globe salvage rate was 76% and 80% with the alternative route subset. Conclusions Alternatives to the OA may be necessary to deliver IAC for selected cases of Rb. These routes can be safe and effective. However, thorough understanding of the orbital blood supply is essential. Whether these alternative IAC methods result in similar outcomes to OA infusions has not been established.
Toward a mechanistic understanding of “peat collapse” and its potential contribution to coastal wetland loss

Abstract Coastal wetlands are susceptible to loss in both health and extent via stressors associated with global climate change and anthropogenic disturbance. Peat collapse may represent an additional phenomenon contributing to coastal wetland loss in organic‐rich soils through rapid vertical elevation decline. However, the term “peat collapse” has been inconsistently used in the literature, leading to ambiguities regarding the mechanisms, timing, and spatial extent of its contribution to coastal wetland loss. For example, it is unclear whether peat collapse is distinct from general subsidence, or what biogeochemical changes or sequence of events may constitute peat collapse. A critical analysis of peer‐reviewed literature related to peat collapse was supplemented with fundamental principles of soil physics and biogeochemistry to develop a conceptual framework for coastal wetland peat collapse. We propose that coastal wetland peat collapse is a specific type of shallow subsidence unique to highly organic soils in which a loss of soil strength and structural integrity contributes to a decline in elevation, over the course of a few months to a few years, below the lower limit for emergent plant growth and natural recovery. We further posit that coastal wetland peat collapse is driven by severe stress or death of the vegetation, which compromises the supportive structure roots provide to low‐density organic soils and shifts the carbon balance of the ecosystem toward a net source, as mineralization is no longer offset by sequestration. Under these conditions, four mechanisms may contribute to peat collapse: (1) compression of gas‐filled pore spaces within the soil during dry‐down conditions; (2) deconsolidation of excessively waterlogged peat, followed by transport; (3) compaction of aerenchyma tissue in wetland plant roots, and possibly collapse of root channels; and (4) acceleration of soil mineralization due to the addition of labile carbon (dying roots), oxygen (decreased flooding), nutrients (eutrophication), or sulfate (saltwater intrusion). Scientists and land managers should focus efforts on monitoring vegetation health across the coastal landscape as an indicator for peat collapse vulnerability and move toward codifying the term “peat collapse” in the scientific literature. Once clarified, the contribution of peat collapse to coastal wetland loss can be evaluated.
Informing HIV Prevention Programs for Adolescent Girls and Young Women: A Modified Approach to Programmatic Mapping and Key Population Size Estimation

Background Standard programmatic mapping involves identifying locations where key populations meet, profiling of these locations (hotspots), and estimating the key population size. Information gained from this method has been used for HIV programming—resource allocation, program planning, service delivery, and monitoring and evaluation—for people who inject drugs, men who have sex with men, and female sex workers (FSWs). With an increasing focus on adolescent girls and young women (AGYW) as a priority population for HIV prevention, programs need to know the location of and how to effectively reach individuals who are at increased risk for HIV but were conventionally considered part of the general population. We hypothesize that AGYW who engage in transactional and casual sex also congregate at sex work hotspots to meet sex partners. Therefore, we adapted the standard programmatic mapping approach to understand the geographic distribution and population size of AGYW at increased HIV risk in Mombasa County, Kenya. Objectives The objectives are several-fold: (1) detail and compare the modified programmatic mapping approach used in this study to the standard approach, (2) estimate the number of young FSWs, (3) estimate the number of AGYW who congregate in sex work hotspots to meet sex partners other than clients, (4) estimate the overlap in sexual network in hotspots, (5) describe the distribution of sex work hotspots across Mombasa and its four subcounties, and (6) compare the distribution of hotspots that were known to the local HIV prevention program prior to this study and those newly identified. Methods The standard programmatic mapping approach was modified to estimate the population of young women aged 14 to 24 years who visit sex work hotspots in Mombasa to meet partners for commercial, transactional, and casual sex. Results We estimated that there were 11,777 FSWs (range 9265 to 14,290) in Mombasa in 2014 among whom 6127 (52.02%) were 14 to 24 years old. The population estimates for women aged 14 to 24 years who engaged in transactional and casual sex and congregated at the hotspots were 5348 (range 4185 to 6510) and 4160 (range 3194 to 5125), respectively. Of the 1025 validated sex work hotspots, 870 (84.88%) were locations also visited by women engaged in transactional and casual sex. Only 47 (4.58%) hotspots were exclusive sex work locations. The geographic and typological distribution of hotspots were significantly different between the four subcounties (P<.001). Of the 1025 hotspots, 419 (40.88%) were already known to the local HIV prevention program and 606 (59.12%) were newly identified. Conclusions Using the adapted programmatic mapping approach detailed in this study, our results show that HIV prevention programs tailored to AGYW can focus delivery of their interventions to sex work hotspots to reach subgroups that may be at increased risk for HIV.